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Corporation 


23  WEST  MAIN  STREET 

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CIHM/ICMH 

Microfiche 

Series. 


CIHM/ICMH 
Collection  de 
microfiches. 


Canadian  Institute  for  Historical  Microreproductions  /  Institut  Canadian  de  microreproductions  historiques 


Tcchnicel  and  Bibliographic  Notas/Notes  tachniqucs  at  bibliographiquas 


Tha  instituta  has  attamptad  to  obtain  tha  bast 
original  copy  availabia  for  filming.  Faaturas  of  this 
copy  which  may  ba  bibiiographically  uniqua, 
which  may  altar  any  of  tha  imagas  in  tha 
reproduction,  or  which  may  significantly  changa 
tha  usual  mathod  of  filming,  are  chackad  balow. 


□    Coloured  covers/ 
Couvartura  de  coulaur 


I      I    Covers  damaged/ 


D 


D 


0 


D 


Couverture  endommagia 


Covers  restored  and/or  laminated/ 
Couverture  restaurie  et/ou  pelliculie 


[~~1    Cover  title  missing/ 


La  titre  de  couverture  manque 


□    Coloured  maps/ 
Cartes  giographiques  en  coulaur 


Coloured  ink  (i.e.  other  than  blue  or  blacu)/ 
Encre  da  coulaur  (i.e.  autre  que  bleu4  ou  ^loire? 


I      I    Coloured  plates  and/or  illustrations/ 


D 


Planches  et/ou  illustrations  en  couleur 


Bound  with  other  material/ 
Relii  avec  d'autres  documents 

Tight  binding  may  causa  shadows  or  distortion 
along  interior  margin/ 

La  re  liure  serrie  peut  causer  de  I'ombre  ou  de  la 
dietorsicn  le  long  de  la  marg«  intirioure 

Blank  leaves  added  during  restoration  may 
appear  within  tha  text.  Whenever  possible,  these 
have  been  omitted  from  filming/ 
II  se  peut  que  certaines  pages  blanches  ajouties 
lors  d'une  restauration  apparaissent  dans  la  texte. 
mais,  lorsque  ceia  itait  possible,  ces  pages  n'ont 
pas  AtA  film^es. 


Additional  comments:/ 
Commentaires  supplimentaires; 


L'Institut  a  microfilm^  le  meilleur  exemplaire 
qu'il  lui  a  iti  po^^sibia  de  se  procurar.  Les  d^ails 
de  cet  exemplaire  qui  sont  peut-dtre  uniques  du 
point  de  vue  bibliographiqua,  qui  peuvent  modifier 
une  image  reproduite,  ou  qui  peuvent  exiger  une 
modification  dans  la  mithode  normale  de  filmaga 
sont  indiquAs  ci-dessous. 

□   Coloured  pages/ 
Pages  de  couleur 

□    Pages  damaged/ 
Pages  sndommagies 

□    Pages  restored  and/or  laminated/ 
Pages  restauries  et/ou  pellicul^es 

Pages  discoloured,  stained  or  foxed/ 
Pages  dicolories,  tacheties  ou  piquees 

Pages  detached/ 
Pages  ditachies 

Showthroughy 
Transparence 

>f  prir 
nAgale 

supple 
Comprend  du  material  suppl^mantaire 

Only  edition  available/ 
Seule  Edition  disponible 


r~~l    Pages  detached/ 
I      I    Showthrough/ 

□    Quality  of  print  varies/ 
Qi^  "t«  in«gale  de  I'i 

□    ..•eludes  supplementary  material/ 
C( 

r~|    Only  edition  available/ 


n 


impression 


Pages  wholly  or  partially  obscured  by  errata 
slips,  tissues,  etc..  have  been  refilmed  to 
ensure  the  best  possible  image/ 
Les  pages  totalemrnt  ou  partiellement 
obscurcies  par  un  feuillet  d'errata.  une  pelure. 
etc.,  ont  iti  filmies  A  nouveau  de  facon  d 
obtenir  la  meilleure  image  possible. 


This  item  is  filmed  at  the  reduction  ratio  checked  below/ 

Ce  document  est  filmi  au  taux  de  rMuction  indiquA  ci-dessous. 


10X 

14X 

18X 

22X 

26X 

30X 

y 

12X 


16X 


20X 


24X 


2ax 


32X 


The  copy  filmed  here  has  been  reproduced  thanks 
to  the  generosity  of: 

National  Library  of  Canada 


L'exemplaire  fiimd  fut  reproduit  grflce  A  la 
g6n6roslt6  de: 

BibliothAque  nationale  du  Canada 


The  images  appearing  here  are  the  best  quality 
possible  considering  the  condition  and  legibility 
of  the  original  copy  and  in  keeping  with  the 
filming  contract  specifications. 


Les  imagos  suivantes  ont  6t6  reproduites  avec  le 
plus  grand  soin,  compte  tenu  de  la  condition  et 
de  la  nettetA  de  l'exemplaire  film6,  et  en 
conformity  avec  les  conditions  du  contrat  de 
filmage. 


Original  copies  in  printed  paper  covers  are  filmed 
beginning  with  the  front  cover  and  ending  on 
the  last  page  with  a  printed  or  illustrated  impres- 
sion, or  the  back  cover  when  appropriate.  All 
other  original  copies  are  filmed  beginning  on  the 
first  page  with  a  printed  or  illustrated  impres- 
sion, and  ending  on  the  last  page  with  a  printed 
or  illustrated  impression. 


Les  exemplaires  originaux  dont  la  couverture  en 
papier  est  imprimie  sont  filmfo  en  commen9ant 
par  le  premier  plat  et  en  terminant  soit  par  la 
derni^re  page  qui  comporte  une  empreinte 
d'impression  ou  d'illustration,  soit  par  le  second 
plat,  salon  le  cas.  Tous  les  autres  exemplaires 
originaux  sont  film6s  en  commenpant  par  la 
premidre  page  qui  comporte  une  empreinte 
d'impression  ou  d'illustration  et  en  terminant  par 
la  dernidre  page  qui  comporte  une  telle 
empreinte. 


The  last  recorded  frame  on  each  microfiche 
shall  contain  the  symbol  -^(meaning  "CON- 
TINUED"), or  the  symbol  y  (meaning  "END"), 
whichever  applies. 


Un  des  symboles  suivants  apparaitra  sur  la 
dernldre  image  de  cheque  microfiche,  selon  le 
cas:  le  symbole  — o»  signifie  "A  SUIVRE",  le 
symbole  V  sigriifie  "FIN". 


Maps,  plates,  charts,  etc.,  may  be  filmed  at 
different  reduction  ratios.  Those  too  large  to  be 
entirely  included  in  one  exposure  are  filmed 
beginning  in  the  upper  left  hand  corner,  left  to 
right  and  top  to  bottom,  as  many  frames  as 
required.  The  following  diagrams  illustrate  the 
method: 


Les  cartes,  planches,  tableaux,  etc..  peuvent  Atre 
film6s  A  des  taux  de  reduction  diffirents. 
Lorsque  le  document  est  trop  grand  pour  dtre 
reproduit  en  un  seul  clich6.  11  est  film6  A  partir 
de  I'angle  supArieur  gauche,  de  gauche  A  droite. 
et  de  haut  en  bas.  en  prenant  le  nombre 
d'images  n6cessaire.  Les  diagrammes  suivants 
illustrent  la  mithode. 


32X 


1 

2 

3 

1 

2 

3 

4 

5 

6 

A' 


COAST    DEFENSES    AGAINST    ASIATIC    CHOLERA. 


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REPORT  OF  AN  INSPECTION 


OF  THE 


Atlantic  and  Gulf  Quarantines 


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IlETWEKN    THE 


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ST.  LAWRENCE  AND  RIO  "iRANDE. 


JO^N  H.  RAUCH,  M.  D., 
Secretary  Illinois  State  Board  of  Health. 


SPRINGFIELD,  ILL.: 
H.  W.  KoKEBB,  State  Printeb  and  Bimdeb. 

1886. 


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COAST  DEFENSES  AGAINST  ASIATIC  CHOLERA.^ 


Eei'ORT  of  an  Inspection  of  the  Quarantines  Maintained  upon  the 

Atlantic  and  Gulf  Coasts  from  the  St.  Lawrence 

TO  THE  Rio  Grande. 


By  John  H.  Rauch,  M.  D.,  Secretary  Illinois  State  Board  Health. 


At  the  July,  1885,  meeting  of  the  Illinois  State  Board  op  Health 
tlie  Secretary  was  instructed  by  a  resolution  of  the  Board  "to  inspect 
"the  methods  of  quarantine  of  the  Louisiana  State  Board  of  Health 
"iind  their  actual  operation  at  the  stations  below  New  Orleans ;  and 
■'also  to  extend  his  inspection  of  quarantine  methods  and  regulations  to 
"such  other  ports  and  places  as  he  may  deem  necessary  in  the  interests 
"of  the  public  health  of  the  State,  with  especial  reference  to  the  exchi- 
"sion  of  Asiatic  cholera  and  small-pox." 

Such  inspection  was  designed  to  supplement  the  action  of  the 
Board — inaugurated  on  receipt  of  the  first  information  that  Asiatic 
cholera  had  again  invaded  Europe,  threatening  another  pandemic 
extension — and  which  action  aimed  to  secure  the  best  attainable  sani- 
tary condition  of  the  territory  under  its  immediate  jurisdiction  as  one 
of  the  most  important  preparations  against  the  spread  of  the  disease 
^vithin  the  State,  should  the  contagion  be  introduced. 

The  geographical  position  of  Illinois — within  24  to  48  hours  of  all  the 
imporiant  ports  on  the  Gulf  and  Atlantic  Coasts — its  commercial  re- 
lations, the  extent  and  character  of  its  means  of  communication,  and 
the  fact  that  fully  one-half  of  the  immigrants  to  this  country  come 
into  or  pass  through  the  State,  most  of  them  remaining  at  least  long 
enough  to  communicate  contagion  and  under  conditions  favorable  to 
such  communication,  obviously  make  the  administration  of  these 
quarantines — with  especial  reference  at  this  time  to  the  exclusion  of 
Asiatic  cholera — a  matter  of  sufficient  importance  to  warrant  the 
Board  in  securing  all  accessible  information  concerning  them,  the  bet- 
ter to  enable  it  to  discharge  its  duty  in  connection  with  the  protection 
of  the  lives  and  health  of  the  citizens  of  the  State. 

In  the  present  epoch  of  quarantine  Illinois  has  a  direct  interest — 
chiefly  commercial — in  the  exclusion  of  yellow  fever  from  the  Mis- 
sisi])pi  Valley;  in  the  exclusion  of  vaccinally-unprotected  immigrants 
at  the  North  Atlantic  ports  for  the  protection  of  her  own  territory  from 
sninll-pox ;  and  in  the  exclusion  of  Asiatic  cholera  generally,  whether 
it  threatens  by  direct  importation  from  Europe  or  mediately  through 
tlio  West  Indies,  Mexico  and  South  America.  In  brief,  the  State  is 
concerned  in  the  condition  of  the  sanitary  coast  defenses  from  the 
mouth  of  the  St.  Lawrence  to  the  mouth  of  the  Rio  Grande. 


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PRRSKNT   HTATUH   AND   PROSPECT'S. 

It  is  hardly  necessary  to  say  that  this  country  is  not  yet  free  from 
danger  of  an  invasion  of  cholera  simply  hecause  there  is  now  a  cessa- 
tion of  alarming  reports  from  Europe.  Periods  of  remission,  more  or 
less  complete,  have  characterized  every  epidemic  spread  of  cholera 
since  it  first  invaded  the  latter  country,  lentil  it  entirely  disappears 
from  the  European  continent  it  will  not  do  for  us  to  relax  our  vigilance 
or  to  remit  a  single  precaution.  On  the  contrary,  this  delay  in  its 
march  should  he  utilized  to  strengthen  our  defenses,  and  to  perfect 
our  precautionary  system.  It  must  he  rememhered  that  the  duration 
of  a  cholera  invasion  of  Europe  is  not  limited  to  two  or  three  years. 
From  the  date  of  its  first  appearance  in  1829-30  in  liussia,  to  its  final 
extinguishment  in  Italy,  Austria  and  Germany,  a  period  of  seven 
years  elapsed,  during  which,  at  one  time  or  another,  every  one  of  the 
Continental  countries  was  invaded — some  of  tiiem  more  than  once. 
Similarly  in  1847,  it  again  entered  Russia  at  two  points,  and  hefore  its 
final  disappearance  in  the  Levant  in  the  winter  of  1855-56,  it  had 
traversed  every  part  of  the  Continent  and  invaded  Great  Britain.  In 
its  last  pandemic  spread  it  appeared  first  at  Malta  in  1865,  continued 
to  ravage  various  parts  of  Europe  until  1869,  when  there  was  a  com- 
plete remission,  only  to  break  out  again  in  1871,  and  finally  disappear 
in  1873. 

With  immigrants  from  every  portion  of  Europe  continuously  land- 
ing upon  o"r  shores  and  rapidly  distributed  throughout  the  interior, 
we  will  no+  freed  from  this  menace  until  every  trace  of  the  conta- 
gion in  t'  :  ^untry  has  vanished.  At  the  close  of  the  year  the  dis- 
ease still  •  viained  in  southern  Spain,  in  France  at  Brest,  in  Italy  near 
Venice,  whence  it  had  spread  to  the  Austrian  port  of  Trieste,  and  it 
has  also  effected  a  landing  on  the  Western  hemisphere,  in  the  French 
penal  colony  Cayenne.  Thus  far  the  disease  has  not  extended  in 
Europe  to  the  regions  whence  our  heaviest  foreign  immigration  is  de- 
rived, and  to  this  fact  is  probably  largely  due  our  present  immunity. 
When  the  German  and  Scandinavian  countries  and  the  British  Islands 
become  infected,  if  they  should,  our  serious  danger  will  then  begin.* 

I  am  often  asked:  "Do  you  expect  to  keep  cholera  out?"  To  which 
my  reply  is,  that  it  is  the  duty  of  every  sanitary  authority  to  try  to  do 
so ;  to  strengthen  the  weak  places  and  perfect  the  strong ;  to  utilize 
every  possible  resource;  to  secure  the  best  attainable  condiHon  of  'us 
OAvn  immediate  territory,  and  to  put  himself  in  a  position  to  receive 
help  from,  or  to  extend  help  to  others  in  fighting  and  excluding  a  com- 
mon foe.  We  may  not  be  able  to  entirely  shut  it  out,  but  it  will  be  a 
great  achievement  if  its  invasion  be  postponed  and  its  spread  limited, 
and  greater  still,  if  it  is  prevented  a  lodgment  in  this  country.  If  an 
outbreak  at  a  port  or  locality  can  be  deferred  until  toward  cold 
weather,  that  ally  would  itself  help  us  to  extinguish  it,  and  it  might 
require  a  fresh  importation  the  next  season  to  start  another.  It  is  our 
duty  to  try  to  shut  it  out,  and  not  fold  our  hands  supinely  and  join  in 
the  condemnation  of  quarantine  and  preventive  methods,  which,  in  a 
great  measure,  are  a  new  outgrowth  since  the  Fever-Summer  of  1878; 
which  have  received  a  great  stimulus  to  development  by  the  present 
dread  of  cholera,  during  the  past  two  years ;  and  which,  so  far  as  they 

♦  Reports  continue  to  appear  in  the  public  press  of  new  outbreaks  in  Spain  and  else- 
where. 


4- 


liavo  been  tested  in  small-pox  and  yello\y  fever,  give  promise  of  suc- 
cess with  the  Asiatic  pestilence.  With  a  sufficient  number  of  National 
icl'uge  stations,  (there  should  be  at  least  one  on  the  Texas  coast 
iiiid  one  tor  New  England,  in  addition  to  those  on  the  Delaware  Bay, 
Hampton  lioads  and  Sapelo  Sound,  and  all  of  them  should  be  aS  fully 
i(|iui)ped  as  that  at  Ship  Island,)  with  properly-appointed  quarantine 
2Htiil)lishments  at  the  larger  ports,  and  mspection  stations  at  the 
siiiiiller  ones,  the  entire  system  to  be  mutually  cooperative,  gov- 
erned by  the  same  general  rules  and  regulations,  kept  fully  informed 
of  public  health  conditions  abroad  by  consular  agents  and  intielligent 
medical  inspectors  when  necessary,  there  would  be  no  reason  to  appre- 
lu'iid  the  introduction  of  cholera  or  any  other  foreign  pestilence. 


n  Spain  and  else- 


QUARANTINE   IN   THE    PAST. 

A  brief  summary  of  the  origin  and  varying  phases  of  quarantine  in 
North  America  will  be  useful  in  this  connection,  mainly  as  serving  to 
emphasize  the  distinction  between  the  ancient  and  modern  systems, 
and  also  for  information. 

From  the  date  of  the  earliest  establishment  of  quarantine  in  this 
country  down  to  the  present  time,  its  efficiency  and  the  public  interest 
in  it  have  been  fitful  and  spasmodic,  dependent  upon  some  real  or 
fancied  pressing  emergency.  The  ravages  of  imported  small-pox  led 
to  the  passage  of  the  first  quarantine  laws  in  1698,  and  these  were 
added  to  from  time  to  time,  and  either  vigorously  enforced  or  more  or 
less  neglected  as  that  disease  increased  or  declined  with  the  conditions 
of  immigration,  and  the  slave-trade.  The  plague  through  Mediter- 
ranean commerce  and  outbreaks  of  yellow-fever  at  long  intervals,  also 
affected  quarantine  laws  and  practice  until  near  the  close  of  the  last 
century.  For  nearly  30  years,  ending  in  1791.  the  country  was  exempt 
from  yellow  fever,  and  during  this  period  little  attention  was  paid  to- 
the  subject.  That  exemption,  it  may  l)e  noted,  was  due  to  the  suspen- 
sion of  direct  commerce  with  the  West  Indies  through  the  enforcement 
of  the  colonial  acts  by  Great  Britain ;  but  after  the  Declaration  of 
hidependence,  commerce  with  the  West  Indies  and  the  Spanish  Main 
Avas  gradually  re-established,  and  in  1791  began  the  yellow-fever  epoch 
of  {[uarantine  following  the  increasing  ravages  of  the  pestilence  in  the 
principal  seaports  of  the  country,  while  small-pox  gradually  lost  much 
of  its  importance  after  the  introduction  of  vaccination  by  Jenner  in 
17!li>.  To  yellow-fever,  after  the  war  of  1812,  and  taking  the  place  of 
small-pox  as  a  quarantinable  disease,  there  was  added  typhus  or  ship 
fover  and  this  disease — aggravated  and  often  developed  during  the 
long  voyages  in  sailing  vessels  with  crowded  steerages  and  a  gross 
ne<ilect  of  hygienic  observances — confined  to  increase  in  frequency 
and  severity  with  the  increase  of  immigration. 

In  18B2,  Asiatic  '•holera  was  added  to  ship  fever  and  yellow  fever, 
and  although  this  new  plague  has  only  affected  quarantine  by  its  four 
ei)idemie  visitations  separated  by  long  intervals  throughout  more  than 
half  a  century,  it  marks  another  epoch  in  quarantine.  Meanwhile, 
the  yellow-fever  zone  in  North  America  had  become  practically  con- 
tracted tc  south  of  Philadelphia — once  the  most  terribly  scourged  of 
American  cities — and  ship  fever  had  lost  much  of  its  significance 
through  the  substitution  of  steamships  for  sailing  vessels,  and  the  en- 
actment and  enforcement,  both  by  this  country  and  by  foreign  countries, 


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6 

of  laws  for  tlio  provcmtion  of  ovc'rcrowdinp;  and  for  the  protection  of  the 
health  of  hnniij^rantH.  With  the  decline  of  ship  fever,  Hn)all-])ox  af,'(iiii 
hej^an  to  increaHc  in  conHefinence  of  a  nef^dect  of  vaccination  or  its  im- 
perfect performance,  and  tliiH  diseaHe  aj,'ain  affected  tlie  puhHc  health 
more  or  less  severely  as  the  tide  of  innni^rution  swelled  or  ehhed. 

Within  the  past  (piarter  of  a  century  small-pox  has  mor«'  than  once 
assumed  epidemic  proporticms,  as  in  the  period  from  IHCiHto  lh75i  and 
from  1H7*J  to  1HH8 ;  yellow  fever  has  prevailed  locally  from  time  to 
time,  and  as  an  e])iden!ic  in  the  ^rississi])pi  VjiUey  in  187?},  187H  and 
1879  ;  cholera  spread  throughout  the  country  in  18()r»-()7,  and  invaded 
nineteen  states  west  of  the  Alle<,du'.nies  in  187M ;  and  these  three  dis- 
eases with  their  varyin<,' manifestations — occasional  lon<f  intermissions, 
followed  hy  violent  and  disastrous  epidemic  outhreaks — have  domi- 
nated the  (luarantine  question  during  this  e])och. 

In  the  few  years  immediately  i)recedin<j;  this  period  some  progress  was 
made  in  an  organized  attempt  to  reform  the  ahuses  of  quarantine,  and 
to  frame  a  system  in  accord  Avith  the  increasing  knowledge  of  epidemic 
diseases — one  whi(di  should  he  freed  from  the  r.miecessary  hardships 
and  rigors  of  quarantines,  revived  or  imjjrovised  in  the  face  of  existing 
danger,  and  too  often  inspired  and  enforced  by  an  unreasoning  dread 
and  terror — similar  to  those  witnessed  in  soutliern  Europe  during  the 
past  two  years.  This  attempt  was  inaugurated  by  Pr.  Wilson  Jewell, 
of  Phihidelphia,  one  of  the  foremost  sanitarians  of  his  day,  and  who, 
in  185(5,  proposed  the  estal)lishpient  of  "a  uniform  (!ode  of  regulations, 
"operating  alike  in  all  respects,  and  offering  the  least  resistance  to  an 
"active  commerce,  and  with  a  humane  regard  for  the  health  of  the 
"passengers  and  crews,  and  the  comfort  of  the  sick  on  board  of  all  ves- 
"sels  detained  at  quarantine  stations."  A  "Quarantine  Sanitary  Con- 
"vention"  was  held  in  1857  for  the  purpose  indicated,  and  some  progress 
was  made  during  its  subse(|uent  sessions  when  the  outbreak  of  the 
Civil  War  put  an  end  to  the  movement. 

It  may  be  here  remarked,  in  passing,  that  these  few  quoted  lines 
indicate  the  essential  features  of  the  quarantine  of  those  days.  They 
were  primarily  quarantines  of  detention  or  exclusion,  inconsistent 
with  an  "active  commerce  ;"  the  "health  of  the  passengers  and  crews. 
"and  the  comfort  of  the  sick,"  were  matters  of  secondary  importance 
and  the  enforcement  of  sanitary  measures  confined  to  proceedings  of  a 
most  primitive  character  where  such  measures  were  attempted  at  all. 
Little  attention  was  paid  to  disinfection,  purification,  isolation  of  the 
sick,  and  the  other  measures  which  now  receive  most  attention.  The 
regulations  entailed  great  personal  sufferings  and  hardships,  and  vex- 
atious delays  and  losses  to  travel  and  traffic,  while  they  generally 
failed  to  protect  the  country  from  the  introduction  of  these  exotic  dis- 
eases. It  is  not  to  be  wondered  at  that  "quarantine"  has  received  so 
much  condemnation. 

COAST  depensp:;s  should  be  under  national  control. 


During  all  this  time,  from  the  earliest  date  to  the  present,  the  con- 
trol of  quarantine  has  remained  entirely  under  the  jurisdiction  of 
State  and  local  authorities,  except  during  the  brief  period  in  which 
the  National  Board  of  Health  exercised  its  limited  quarantine  powers 
under  the  act  of  1878  and  which  expired  in  1882.    It  is  this  absence  of 


!i(l('(|uate  Niitioiial  health  authority  and  le«,M8hitioii,  uiul  the  fact  that, 
ill  such  al)Ht'nce  the  maritinu'  (luarantincH  are  controlh'd  ami  admin- 
istered by  State  inid  loeal  autlioritieH — resulting  in  diverse,  and  fre- 
(|iiently  contlieting,  rejjtulations  and  requirementH  and  of  necessity, 
ill  a  tendency  to  limit  i)reeautionH  to  their  own  individual  interests, 
(•(iinmercial  as  well  as  sanitary — wliicdi  throw  upon  interior  States 
flic  responsibility  of  fully  informinj^  themselves  of  the  strength  or 
weakness  of  these  outposts,  in  ortler  to  know  where  to  antieii)ate  dan- 
1,'er  and  how  to  make  their  own  preparations  to  meet  it. 

At  its  Inst  session.  Congress  appointed  a  commission  to  examine  and 
report  upon  the  measures  necessary  for  the  defense  of  our  seacoast 
at,'ainst  a -foreign  armed  enemy,  and  a  distinguished  ]tul)li('ist  and 
statesman,  Mr.  Tilden,  has  recently  urged  this  as  a  paramount  duty  of 
the  Govenmient.  Millions  of  dollars  have  already  been  expended 
peuded  for  such  defense,  and  millions  UKU'e  wdl  probably  be  forth- 
coining  to  meet  this  possible  contingency.  But  the  assaults  of 
foreign  contagion  are  not  a  contingency.  They  are  actual  events, 
and  during  tlie  past  twenty  years  they  have  cost  the  country,  an 
afrgfegate  loss  of  life  only  less  than  that  of  the  great  war  imme- 
diately preceding.  Every  sanitarian  and  many  of  our  leading 
statesmen  know  tliat  this  actual  and  ever-recurring  loss  is  vliolly  and 
entirely  preventable  by  the  expenditure  of  a  sum  which  sinks  into 
utter  insignificance  before  the  millions  which  will  be  appropriated  for 
the  protection  of  our  coasts  against  a  possible  futcure  danger. 

But  thus  far  neither  sanitarian  nor  statesman  has  been  able  to  over- 
come the  petty  jealousies  of  individuals,  communities,  and  of  States 
themselves,  so  as  to  secure  the  legislation  necessary  to  remedy  even 
the  present  confusion.  Such  sanitary  measures  as  are  now  enforced 
l)y  the  National  Government  are  based  upon  authority  derived  from 
the  act  of  April  29,  1878,  to  prevent  the  introduction  of  contagious  or 
infectious  diseases  into  the  United  States.  But  the  late  Secretary  of 
State,  Mr.  Frelinghuysen,  and  the  late  Secretary  of  the  Treasury,  Mr. 
Folger,  both  decided  that  the  act  in  question,  having  been  repealed  by 
the  act  of  June  2,  1879.  could  not  be  revived  by  the  expiration  of  this 
latter  act.  The  point  would  have  less  practical  importance  if  the  au- 
thority which  assumes  to  act  under  it  can  and  will  furnish  the  country 
the  necessary  protection'  in  the  present  emergency.  Practical  sanitary 
executives  are  less  concerned,  just  now,  as  to  who  exercises  the  au- 
thority and  by  what  right,  than  in  the  questions :  Is  the  authority 
wisely  exercised  ?  Is  it  sufiticient  ?  May  we  rely  upon  it  implicity '? 
If  not,  to  what  extent,  and  how  can  we  remedy  its  deficiencies  ? 

It  is  by  no  means  meant  by  this  that  it  would  not  be  better  that 
there  should  be  a  properly  organized  National  health  department,  act- 
ing under  clear  and  undisputed  legal  authority,  and  supplied  with 
funds  adequate  to  its  legitimate  necessities.  The  present  status  of 
National  sanitary  legislation  and  of  the  National  sanitary  executive 
is  admittedly  defective  and  unsatisfactory.  The  history  of  the  recent 
attempts  to  control  the  disinfection  of  rags ;  the  complications  at  the 
port  of  New  York  concerning  consular  bills  of  health ;  the  strictures 
upon  the  inspection  service  maintained  along  the  coast,  and  in  the 
matter  of  inspections  on  the  Canadian  frontier  during  the  recent  small- 
pox epidemic ;  the  complaints  of  various  boards  of  health  that  they 
are  directed  to  look  to  the  associated  press  for  information  and  warn- 
ing concerning  threatened  danger  from  abroad,  to  their  ports  and 


II; 


v,» 


w 


tonitory*   -imd  many  otlior  siiniliir  iimttorH  point  to  tlm  ncccsHity  U) 
a  W(*ll-('()nHi(K'it'(l  iind  nuliciil  roviHion  of  o\istiii{^  Niitional  Hunitaiy 
loKiHlation. 

Consular  billH  ol'  licaltli.  which  nw  now  an  a  vnh  aliiioHt  worthless, 
inif,'ht  ln)  made  of  tlio  greatest  viihic;  and  thi'sc.  toK^'tlicr  with  tlu- 
prompt  ptd)licati()n  of  (liroct  and  ollicial  information  concc^rnin},'  the 
Hanitary  wtatuH  of  foreifjtn  ports — hucIi  information  to  ho  Hocurcd  hy 
compi't«'nt  porHons — are  tfHHcntial  to  the  to  the  pn-vention  of  the  intro- 
duction of  foreign  conta^'ion.  Ohviously  Huck  meaHureH  can  he  wan- 
lated,  controlled  and  jjrovidtrd  only  l)y  the  National  government. 


liU 


w^ 


*'>■%)    'J    MP- 

1      1  I ' ' 


^ 

t 

r 

iii' 

I  ''  ' 

iff!™' 

> 

rOHHIItllilTIKH   OF    I'tlMSKNT   COAST    OEKKNSEH. 

NevertheleHH,  I  am  more  than  ever  convinced,  since  comphiting  this 
inspection,  that  Asiatic  cholera,  as  well  as  snuill-pox  and  yellow  fever, 
may  1)»'  etfectually  ex(duded  from  the  llnited  States  hy  an  intellif^ent 
use  of  tiie  a<j;encies  still  at  our  command.  This  is  not  a  matter  of 
speculation  or  theory.  A  ^raat  advance;  has  heen  made  since  1878.  A 
quarantine  of  exclusion  of  these  three  diseases  is  now  a  matter  of  cer- 
tainty, depending  upon  ])romi)t  notification  of  threatened  dan<?er;  vig- 
ilant supervision  over  connnercial  intor(H)urse  with  infected  localities : 
inspection  of  all  immi<i[rants  and  the  enforcement  of  their  vaccinal 
j)rotection;  sanitation  and  purification  of  infected  vessels  and  cargoes; 
isolation  of  those  sick  with  these  diseases  ;  the  surveillance  of  suspects 
(luring  the  periods  of  incuhation ;  and  the  employment  of  other  well- 
defined  preventive  and  i)recautionary  measures  which  now  con- 
stitute the  hest  modern  sanitary  practice  as  applied  to  maritime 
quarantine. 

Cholera  has  never  yet  heen  kept  out  of  this  country  after  hecoming 
epidemic  in  Europe,  and  I  admit  that  ipiarantines,  as  conducted  in 
that  country,  have  proved  inelTectual  to  control  the  spread  of  the  dis- 
ease. But  the  conditions  vhich  ol)taiii  here  are  radically  different 
from  those  in  Europe.  In  that  country,  as  I  have  said  elsewhere,'  ii 
narrow  strait  or  sea,  a  river,  a  mountain  chain,  or  merely  a  territorial 
houndary  line,  with  its  custom-houses  and  pnssport  system,  defines  the 
limits  to  he  guarded,  and  forms  the  only  ])hysical  harrier  hetween  the 
quarantiner  and  the  (piarantined.  Here,  the  whole  width  of  the  At- 
lantic intervenes  hetween  us  and  the  infected  country.  There,  cordons 
and  (inarantiiies  mean  privation,  misery  and  suifenng,  and,  ultimate- 
ly, starvation.  Here,  the  Nation  could  exist  unaffected  in  all  her  ma- 
terial interests  hy  a  quaranthie  whose  period  of  detention  is  limited  to 
the  time  necessary  to  destroy  contagitm  through  the  rapid  processes 
of  modern  disinfection  and  sanitation.  There,  it  may  be  true,  as 
alleged,  that  a  (piarantine  of  exclusion  is  impossible  of  execution,  and 

♦Both  for  tlu*  TrjiiNois  State  Hoaud  of  Health  as  its  Sccrctury,  and  for  tlid  Sanilaiv 
Council  of  tli(>  Mississippi  Valley  as  its  i-xccutivo  i)(ll('or,  I  liav(.'  attcnipttMl  to  secure  siicii 
Infornuition— asking  for  copi(>s  of  consular  report s,  or  tl.e  essential  facts  contained  tliorciii, 
as  to  the  existence  of  epidemic  contii^jious  diseases  at  ports  in  eomnuTcial  relation  with 
this  country  and  with  especial  reference  to  Asiatic  iduilera:  also  for  the  addresses  of  nicdi- 
eal  inspoi'tors  stationed  at  foreign  ports, etc.  'I'he  Sei'retary  of  Slat(^in  acknowledKinh'llic 
receipt  of  my  requf^sts,  stated  tliat  they  had  heen  referred  to  the  Treasury  IJepartniciit, 
iuformiiiK  nie  in  (^ffei't,  that  charge  of  all  nuitters  pertaining  to  the  public  health  w:is 
assuMUMi  by  that  brunch  of  tlie  National  government.  No  reply  has  yet  been  received 
from  the  Treasury  Department  nor  from  any  of  its  bureaus. 

tPractieal  Ueeommcndations  for  the  Exclusion  and  Prev(^ntion  of  Asiatic  Cholera  in 
North  America.  An  Address  d(>li.'ered  at  the  opening  of  the  National  Conference  of  Stfite 
Boards  of  Health,  8t.  Louis,  Mo„  October  i;{-]5,  IHS4. 


9 


ncct'HHity  fii 
jual  Hiinittu-y 

Ht  worthless, 
Ikt  uitli  tliv 
iicorniii}^  tile 

0  Hocurcd  l)y 

1  of  tho  intro- 
ciin  l»c  rcj^ii- 

•iimeut. 


mplotiiif,'  tliis 

yellow  fever, 
in  intelligont 

a  matter  of 
ince  1878.  A 
latter  of  cer- 

(laiiser;  vig- 
ed  localitios ; 
heir  vaccinal 

and  cargoes; 
.'e  of  HUHpectH 
>f  other  well- 
h    now    eon- 

to  maritime 

ter  hecominR 
(conducted  in 
a\  of  tho  dis- 
ally  different 
elHewhere,'  a 
r  a  territorial 
n,  defines  the 
between  the 
h  of  the  At- 
lere,  cordons 
id,  nltiniate- 
1  all  her  ma- 
is  limited  to 
)id  processes 
be  true,  as 
ecution,  and 

for  tli(<  Siinitary 
I  to  socun'  siii'li 
iitaiiuMl  thorriii, 
iul  relation  with 
ilrcsHcH  (if  nicili- 
knii\vliHlf,'inK(li'' 
try  ncpartnii'iil. 
iltlni  hoiiltli  was 
)t  been  received 

iatie  Cholcni  in 
rt'i'cnct!  of  iStato 


tli;ii  the  attempt  to  maintain  it  does  mon*  harm  than  ^ood,  in  leading 
til  immlterless  contraltand  i)racticeH  Ijy  whieli  the  diHease  may  he  in- 
truihiccil  in  nnsnspected  ways.  None  of  this  is  true  wlien  applied  to 
till'  exclusion  of  Asiatic  cholera  from  this  country;  while  to  accejjt 
the  stateUK^ntH  un(|uestioned  would  cause  \i^'ilance  to  he  relaxed, 
would  invite  conta}j;ion  to  our  shores  unimpeded,  and  would  finally 
tlirow  upon  individual  conununities  the  burden  and  the  responsibility 
(if  li^ditiufjj  the  disease  at  an  imnu'use  disadvantajjie  that  is,  of  lif»ht- 
iiii;  it  at  Ikuuc  ami  from  numy  (luarters,  instead  of  on  the  outer  lines 
and  from  only  (me  direction. 

Those  outer  lines,  even  with  some  defects  and  weak  places,  T  Ixdieve 
to  be  even  now  sutViciently  strong,'  to  keep  out  the  disease  if  i)ro))er 
viiidance  and  thorouf,'hness  be  ex»'rcised,  if  all  the  facilities  be  utilized, 
and  if  timely  notification  of  threatened  danj^er  be  f,'iven  by  the  National 
^'overnment. 

The  next  year  or  two,  however,  will  furnish  a  tolerably  conclusive 
test  of  the  erticiency  of  cpuirantine  to  exclude  the  pestilence  from  this 
country. 

lMMi;niATK  RESULTS  OK  THE  INHl'ECTION. 

During  the  progress  of  the  inspection  it  was  observed  that  the  com- 
piuisons  institut(!d  and  the  information  furnished  prompted  (|uarantine 
otlicers  and  health  authorities  to  avail  themselves  of  facilities  pre- 
viously overlooked  or  neglected,  and  to  put  themselves  in  communica- 
tion with  each  other  for  purposes  of  mutual  cooperation  and  sup- 
port. At  many  of  the  statitms  those  in  charge  invited  criticism  and 
Kiif,'j,festions,  while  others  would  not  rest  satisfied  until  their  facilities 
and  a])])liances  were  made  more  complete.  Suggested  improvements 
have  already  been  made  in  many  instances  and  others  will  doubtless 
1)1'  secured. 

Not  the  least  among  tho  good  results  which  are  already  perceptible 
is  the  recognition  of  tho  fact  that  tlu^  administration  of  quarantine  at 
a  ^'iven  port  is  not  a  purely  local  measure  ;  but  that  tho  country  back 
of  it.  and  communities  distant  in  space  but  in  close  proximity  in  point 
of  time,  are  also  interosted.  Since  States  and  communities  continue 
to  control  maritime  quarantine,  and  in  many  instances  are  jealous  even 
ofii  suggestion  of  Federal  interference,  it  is  right  that  they  should  recog- 
nize the  full  import  of  their  obligations.  Nor  should  they  overlook  the 
fiict  that  these  distant  communities  have  the  power  to  both  help  and 
punish.  Illinois,  for  example,  by  recently  refusing  entrance  to  immi- 
1,'nints  coming  through  ports  which  were  lax  in  enforcing  vaccinal 
l)votecti(m,  furnished  a  powerful  argument  to  the  quarantine  officers 
iit  such  ports  whereby  they  secured  compliance  with  their  requirements 
liy  the  steamship  companies.  This  retiex  action  may  bo  carried  still 
further.  If  a  port  or  locality  should  notoriously  disregard  the  pre- 
oautions  necessary  to  prevent  the  access  of  cholera  it  would  be  an 
obvious  duty  of  self-protection  not  only  to  exclude  immigrants  but  to 
cut  oft'  all  intercourse  with  such  port  or  locality.  With  the  danger 
of  such  a  contingency  clearly  recognized  the  authorities  would  not 
only  be  apt  to  exercise  proper  vigilance,  but  all  transportion  and  com- 
mercial agencies — railroads  and  steamships — would  become  quaran- 
tine aids.    Captains  and  officers  would  have  an  additional  incentive 


■i" 


I    ■ ; 


-~^' 


•S'*!  it 


10 


VWi 


for  keeping  their  vessels  in  good  sanitary  condition  and  for  promptly 
reporting  cases  of  suspicious  sickness  during  the  voyage  if  it  came 
to  be  understood  tliat  faihire  in  these  respects  would  he  followed  by 
loss  of  trade  and  employment. 

One  obvious  advantage  which  may  be  expected  to  follow  the  publi- 
cation of  this  report,  will  be  the  notification  to  all  interested  of  the 
weak  places  in  our  line  of  coast  defenses,  and  this  will  naturally  ensure 
greater  care  and  vigilance  at  such  places  and  greater  watchfulness  of 
them  by  others. 


dii 


To  some  places  which  I  was  unable,  from  want  of  time  and  pressure 
of  other  duties,  to  personally  visit  and  inspect,  the  following  series  of 
questions  was  addressed,  and  subsequent  correspondence  elicited  the 
necessary  information  in  such  cases : 

1  What  are  the  quarantine  facilities  at  your  port '?  Please  furnish 
copy  of  laws  or  ordinance^,  and  of  rules  and  regulations. 

2.    How  far  from  the  city  is  the  quarantine  station? 

Is  the  station  out  of  the  track  df  commerce  or  travel  ? 

How  far  from  the  city  are  vessels  inspected  ? 

How  are  vessels,  cargoes  and  persons  disinfected  and  purified  ? 
fi.    What  are  the  periods  of  detention  and  seasons  ? 

7.  How  would  a  cholera- infected  vessel  be  treated? 

8.  Under  what  circumstrnces  would  vessels  be  sent  to  the  nearest 
refuge  station  ? 


3. 
4. 

5. 


m 


11 


ATLANTIC  AND  GULF  COAST  QUAEANTINES, 

1,0(  ATioN  OF  Stations,  Equipment,  Poweus  and  Authouity,  Huleh  and  IIegui.ations, 

Methods,  etc.,  etc,,  fuom  Canada  to  Texas,  inclusive. 

Akbanoed  CIkogkaphically. 


Pleas(  furnish 


;o  the  nearest 


Canada : 

On  the  !)th  and  10th  of  October,  I  made  an  inspection  of  the  Grossc  Isle  (luarantine 
estalilishment,  on  the  8t.  Lawrence  river,  about  3  miles  below  (^uob(>c.    Dr.  F.  Montizam- 
bei't,  Chief  Quarantine  Officer  of  the  Dominion,  telegraphed  me  on  the  !tth  that  he  would 
send  his  yacht  to  meet  me  at  St.  Thomas,  a  station  on  the  Inter-Oolonial  railway,  about 
;!ii  inilos  from  Quebec.     We  left  the  wharf  at  this  place  about  4:30  p.  m.,  but  owing  to  head 
winds  wore  unable  to  use  the  sails,  and  the  men  had  a  weary  pull  of  two  hours  and  a  'lalf 
to  make  the  five  miles  to  the  station  against  the  strong  current  and  ebb  tide.    \s  this  boat 
i<  the  sole  means  which  the  station  possesses  for  boarding  a  vessel  foe  inspection  pur- 
liosus,  I  became  (luite  convinced  that  a  steam  yacht  or  launch  is  a  necessity  in  such  a 
swift  current  and  with  such  high  tides  as  obiain  in  this  stream,  the  channel  being  fully  two 
and  one-half  miles  from  the  station.    The  Orosse  Isle  auar.antine  station  is  an  island  about 
one  and  one-half  miles  long,  divided  into  Sick,  Central  and  Healthy  Divisions.    In  the  Sick 
Division  ai-e  the  hospitals  with  the  necessary  adjuncts.    There  is  a  two-story  brick  hospi- 
tal, with  100  beds,  including  some  in  private  wards  for  cabin  passengers   ship's  officers, 
eto.;  and  a  one-story  wooden  shed  with  about  seventy  beds.    There  are  also  ample  facilities 
for  disinfection,  and  for  the  purification  of  clothing,  etc.    In  the  Central  Division  are  the 
iiuanintine  officer's  and  chaplain's  residences,  and  iiuarters  for  the  employes,  eight  in 
number,  embracing  a  hospital  stmvard,  a  sergeant  of  police  (who  speaks  four  languages),  a 
baker  and  the  boat's  crew.    From  this  point  ships  tliat  stop  opposite  the  station  for  inspec- 
tion arc  gone  out  to.    In  the  Healthy  Division,  (a  mile  and  a  (luarter  from  the  hospital),  are 
the  houses  of  detention  with  aecommodatioi^s  for  about  2,000  persons:  a  large  wash-house: 
a  bakery:  a  furnace  for  hot-air  disinfection;   rooms  specially  arranged  for  fumigation; 
I'haix'ls,  police  barracks,  etc.     There  is  telephonic  communication  between  the  diff'eront 
divisions  of  the  station,  and  telegraphic  to  Quebec.   The  disinfectants  employed  are  (ddor- 
idcoflinie,  corrosive  sublinnite  and  sulphurous-acid  gas.     Labarraciue's  solution  is  also 
used  for  the  sponging  and  washing  of  patients  and  attendants,  and  permanganate  of  pot- 
ass for  coloring  dangerous  solutions;  chloride  of  lime  in  solution,  four  ounces  to  the 
gallon,  is  used  in  the  vessels  which  receive  the  discharges  of  the  sick.     Infected  clothing 
and  bedding  are  steeped  at  once,  in  the  wards,  in  a  weaker  solution  of  clilorido  of  lime  or  ol 
ocrrosivo  sublimate,  and  t;ien  boiled  befoi-e  being  sent  to  the  wash.    The  dry-heat  oven  is 
rarciy  used:  what  can  not  he  steeped  for  at  least  two  hours,  and  then  boiled  for  at  least 
half  an  hour  is  generallv  burned,  in  the  absence  of  a  steam  disinfcctor.     For  fumigation, 
sulphurous-acid  gas  is  used  in  closed  apartments  either  from  burning  the  crude  sulphur, 
or  from  the  copiier  reservoirs  in  which  it  lias  been  stored  under  pressure,  and  which  arc 
olitaiiicd  from  New  York. 

Siiould  a  vessel  arrive  here  with  cholera.  Dr.  Monti/ambcrt  purposes  to  treat  her  as 
follows:  Land  the  sick  and  their  attendants  directly  at  the  Sick  Division,  with  every 
thing  suspected  connccti-d  with  them.  Land  all  the  steerage  passengers  and  their  effects, 
and  iilace  them  in  the  detention  houses  at  the  Healthy  Division.  Open  all  windsails,  hatches' 
!>ortliolos,  etc.,  on  the  vessel;  have  the  bilgc-water  repeatedly  pumped  out  or  changed; 
Hupplv  umiucstionable  drinking  water  to  jill.  All  the  luggage  of  the  cabin  passengers  and 
111!'  clVi'cts  of  the  crew  to  be  opened  out  on  boanl;  all  body  and  lied  linen  to  be  steeped  in 


12 


h-^n   ; 


1 «  I  fC 


1  1 


f  1', 


solution  of  coiTOHive  sublimate;  and  other  ellVcts,  witli  tlie  oponed  trunks,  etc.,  to  be  n: 
peatodly  fumieftted  with  sulphurous-ueid  gas  in  closed  aiiartmcnts.  The  vessel  in  all 
attainable  parts,  and  notably  the  cabins,  steerage  and  forecastle,  to  be  scrubbed  with  solu- 
tion of  corrosive  sublimate  and  fiiniigatiKl.  The  cargo  to  bo  opened  up  in  as  many  places 
as  possible,  and  then,  the  hatches,  etc.,  being  closed,  the  compressed  sulphur  dioxide  to 
be  poured  In  amongst  it  from  the  reservoirs.  Should  it  seem  necessary,  the  cargo  would 
be  landed  to  allow  of  its  more  detailed  disinfection,  and  the  more  satisfactory  treatment 
by  washing,  rinsing  with  corrosive-sublimate  solution  and  fumigation  of  the  empty  vessel. 

Whilst  the  vessel  and  those  on  bonrd  are  thus  being  attended  to  the  steenige  passen- 
gers and  their  effects  are  washed  and  disinfected  on  shore  at  the  Healthy  Division.  The 
attendants  being  always  amongst  them,  would  report  by  telephone  at  once  any  slightest 
appearance  of  illness,  and  in  addition  a  regular  medical  '.'ispection  is  made  twice  daily 
of  all  those  under  detention,  viz:  At  it  a.  m.  and  4  p.  m.  each  day.  Any  one  showing  even 
doubtfid  symptoms  is  at  once  removed  from  amongst  the  others,  placed  in  a  ward  of  ob- 
servation and  <^hence  returned  to  the  Healthy  Division  or  taken  to  hospital  as  may  be  re- 
quired. Subso(iuent  to  completed  process  of  disinfection,  the  vessel,  passengers  and  crew 
would  be  detained  for  eight  clear  days  after  the  occurrence  of  the  last  cholera  case  before 
being  admitted  to  prati(iue. 

The  process  thus  described  is  carried  out  with  any  vessel  that  arrives  with  an  infect- 
ious disease  difl'ust^d  amongst  its  passengers,  except  that  the  vessel  is  allowed  to  proceed 
after  disinfection  without  further  detenci';n.  With  a  cholera  ship,  however,  application 
would  be  made  by  telegraph  for  authority  to  detain  the  vessel  and  all  on  board,  and  it 
would  probably  be  aiicorded. 

Grosse  Isle  was  for  a  K  ng  while  one  of  the  most  important  (luarantine  stations  on  this 
continent.  Over  15, 000  victims  of  cholera  and  ship  fever  are  buried  on  the  island.  It  was 
established  during  the  sailing-vessel  period  wlien,— as  the  result  of  the  long  voyage, 
crowded  steerage  and  ignorance  or  disregard  of  all  sanitary  and  hygienic  observances 
—almost  every  arrival  was  more  or  less  infected.  For  the  requirements  of  tbe  period,  it 
was  probably  as  well  adapted  and  as  completely  e(iuipped  as  any  establishment  in  the 
■world.  The  vessels  then  in  use  could  easily  approach  its  wliarf  and  receive  such 
treatment  as  was  at  that  time  considered  necessary. 

But  with  the  advent  of  the  huge  ocean  steamships— with  their  great  draueht,  short 
passages,  improved  accomni':^dations,  and  imperative  demand  for  "(luick  dispatch"— the 
station  has  lost  Much  of  its  importance.  One  set  of  conditions  has  largely  obviated  its 
necessity  as  a  barrier  against  the  introduction  of  epidemic  contagion,  while  another  set 
has  created  a  necessity  for  improvements  and  modifications  which  have  not  been  made. 
As  a  eonse(iuence,  there  is  loss  attention  paid  to  the  maintenance  of  the  station  and  to  the 
enforcement  of  the  regulations.  During  the  season  up  to  the  9tli  of  October,  tlio  date  of 
my  inspection,  only  32  vessels  out  of  a  total  of  420  arrivals  had  stopped  at  the  station  lor 
examinaticn. 

My  observations  and  study  of  the  jnactmonts  suggest  the  following  as  among  the  more 
important  nuitt(>rs  reiiuiring  attention,  if  this  station  is  to  be  relied  upon,  to  prevent  an 
invasion  of  cholera  or  otlit  r  grave  epidemic  contagious  disease  via  the  Kt.  Lawrence  livcr* 
—having  ri'gard  on  the  one  'land  to  the  efilciency  of  service,  and  on  the  other  to  the  inter 
ests  of  coninierci': 

1.  The  hoarding  at  lUmouski  and  inspection  of  the  mail  steamers  is  an  absoiute  nccos 
sity,  and  all  foreign  vessels  bound  up  should  be  inspected  at  or  below  Gross'   Isle,  so  that 
it  the  vessel  netuls  to  be  detained  at  (luaraiitine  the  fact  can  be  promptly  ascei  lained,  and 
if  healthy  and  free  from  danger  of  conveying  infection  or  contagion,  she  may  proceed 
without  unnecessary  delay. 

2.  The  revision  of  the  regulations  so  as  to  secure  the  compulsory  sending  back  to 
«iuarantine  of  any  vessel  that  passes  up  to  Quebec  without  having  been  inspected,  no  ves- 
sel to  be  allowed  to  enter  the  custom  house  at  Quebec  or  Montreal  without  first  exhiliitinc 
the  cortillcato  of  the  inspecting  medical  onic(3r. 

3.  Better  facilities  for  boarding  vessels  at  the  (juarantine  station  are  re(iuired  as 
already  suggi^sti^d. 

♦  Cholei  a  was  introduced  into  this  counti  y  by  this  route  in  181(2. 


13 

4.  The  adoption  of  some  of  the  jnore  modern  appliances  for  disinfection,  as  for  exam- 
lili',  a  stonm  disinfector  for  rags,  textile  fabrics,  etc.,  or  the  methods  employed  at  the  Mis- 
sissippi (luarantine  of  the  Louisiana  State  Board  of  Health. 

t").    The  vaccinal  protection  of  the  immigrants  should  be  enforced. 

(!.    The. addition  of  another  medical  ofttcor  to  the  stalT  of  the  station.  ! 

7.  Should  it  be  impracticable  to  thoroughly  disinfect  a  vessel  or  cargo,  wharfage  facil- 
ities, in  addition  to  those  oxis-ting  at  present,  should  be  provided  for  vessels  of  the  heaviest 
draft  t),.it  n.'ivigate  the  8t.  Lawrence. 

The  modiflcatlQ-s  herein  briefly  indicated,  with  the  facilities  already  possessed  and  the 
natural  advantages  fully  utilized,  would,  to  a  great  extent,  remove  the  apprehension  of 
iholeraflndingits  wny>into the  country  through  the  St.  Lawrence,  and  would  materially 
obviate  the  necossit>  of  restrictions  over  traffic  and  travel  between  the  Dominion  and  the 
United  States.  Sweeping  and  onerous  requirements,  entailing  unnecessary  expense  and 
delay— especially  if  such  expense  and  delay  be  due  to  inadeiiuate  equipment  and  appli- 
ances—defeat  the  very  object  of  quarantine  and  provoke  avoidable  hostility  and  opposi- 
tion, or  lead  to  neglect  and  indifference.  In  order  to  make  a  quarantine  effective  as  a 
safeguard  of  the  public  health,  nothing  should  be  required  which  is  not  clearly  necessary; 
the  facilities  and  regulations  should  be  such  as  to  insure  a  minimum  of  interference  and 
inconvenience  consistent  with  the  end;  and  every  necessary  requirement  should  be  rigidly 
continuously  and  Impartially  enforced. 

The  only  diseases  requiring  attention  at  the  present  time  are  cholera  and  small-pox. 
Up  to  the  time  of  my  visit  the  vaccinal  protection  of  immigrants  was  not  enforced,  and 
small-pox  had  repeatedly  been  introduced  into  Illinois  and  the  Northwest  by  unvaccinated 
immigrants  coming  through  the  Dominion.  Since  my  inspection,  no  unprotected  immi- 
grant is  allowed  to  land,  and  under  the  present  regulations  the  risk  of  imported  small-pox 
pontagion,  via  the  St.  Lawrence,  is  very  materially  reduced.  A  steam  yacht  has  also  been 
ordered  to  take  the  place  of  the  yacht  for  boarding  vessels  at  Grosse  Isle.  Upon  this  will 
b<j  placed  the  modern  appliances  for  disinfection  above  indicated. 

During  my  inspection  I  was  urged  to  make  my  criticisms  and  suggestions  direct  to  tho 
quarantine  olffcer,  and  subsequently  the  Dominion  government  invited  me  to  communi- 
cate the  same  to  them. 

In  addition  to  the  quarantine  on  the  St.  Lawrence  there  are  two  other  quarantine 
stations  maintained  by  the  Dominion  government— one  on  Partridge  island,  for  the  port 
of  St.  Johns,  N.  B.,  and  one  on  Lawlor's  island,  for  tho  port  of  Halifax.  These  are  subject 
to  the  same  enactments  as  apply  to  the  Dominion  generally. 

Dr.  W.  W.  Wickwire,  Inspecting  Physician  for  the  port  of  Halifax,  writes  mo,  under 
date  November  20th,  "tho  quarantine  station  is  on  an  island  in  the  harbor  of  Halifax,  about 
three  and  a  half  miles  from  tho  city.  This  island  is  owned  by  the  Dominion  govnrnment, 
and  is  used  entirely  as  a  quarantine  station— the  only  persons  living  there  permanently 
are  tho  steward  and  his  family.  The  island  (Lawlor's)  has  an  area  of  about  150  acres. 
There  are  now  hospital  buildings  affording  accommodations  for  about  100  persons,  but 
additional  Ijuiklings  could  easily  and  rapidly  be  constructed. 

The  quarantine  anchorage,  whore  inspection  takes  place,  is  about  tlu-fjo-quartcrs  of 
a  mile  Irom  the  city.  Pilots  are  required  to  bring  all  vessels  iftto  this  anchorage  ground 
if  there  bo  any  disease  whatever  on  board,  and  there  remain  until  inspected." 


are   re(iulred  as 


Maine: 

The  Navy  Department  has  been  in  the  habit  of  sending  yellow-fever  infected  vessels 
to  tho  Navy  Yard  at  Portsmouth,- Now  Hampshire,  but  owing  to  protests  by  tho  citizens, 
of  that  city,  against  such  action,  Dr.  F.  M.  Gunnell.  Surgeon-General,  under  authority  of 
tliu  Secretary  of  the  Navy,  in  1884,  established  a  refuge  station  on  Widow's  Island,  in 
Ponobscott  Bay. 

A  tempo  -ary  hospital  and  quarters  for  offlcors  have  been  built,  and  an  artesian  well 
bored,  from  vvhich  an  abundant  supply  of  good  water  has  been  obtained  at  the  depth  of 
sixty  feet.  "The  island  is  (ionvenient  of  access  from  the  sea,  has  excellent  anchorage  pro- 
tected from  storm  winds,  and  affords  a  safe  and  desirable  refuge  for  infected  vessels  com- 
ing north  from  the  West  Indies  or  Gulf  of  Mexico."    The  Surgeon-General  recommends 


"If 


vr 

t'T   .«. 


MA 


-)  , 


H>, 


I?  r  i  ■, 


14 

In  his  report  bonriiiB  date  Ootob(>r  1. 1SH5,  tlmt  pornianent  buildings  bd  erected  at  this  pluno; 
and  a  stronKly  i^onstriu^ted  wharf,  to  facilltato  tiio  landing  of  heavy  Htores  from  vesHnls 
in  or<i('r  to  acconvpUsh  thoroiigli  fumigation  and  disinfeetion.  Witli  the  exception  of  this 
station  there  are  no  (luarantinefacilitieH  along  the  eoant  of  Maine,  an<l  this  is  under  the  .'oii. 
ir>):  of  the  Navy  Department.  Why  should  it  not  bo  utilized  as  a  refuge  station,  incase 
cholera  is  found  on  vessels  in  this  neighborlioodV 

I  visited  Portland  in  August  last,  on  account  of  the  importance  it  possesses  in  thia 
connection,  owing  to  its  being  the  winter  port  of  the  Grand  Trunk  railway,  and  thus  re- 
ceiving a  considcHiible  immigrant  travel  during  tlie  winter  montlis.  I  found  that  inspec- 
tions were  made  only  upon  the  arrival  of  vessels  at  the  wharf,  wlion  they  are  boarded  by 
the  city  physician.  If  contagious  disease,  such  as  small-pox,  be  found  on  a  vessel,  it 
would  be  ordered  to  the  quarantine  groun<ls  about  two  miles  from  the  city:  those  on  board 
would  be  vai'cinatcd,  and  sucii  disinfection  enforced  as  might  be  practicable  under  the 
circumstances. 

The  iittention  of  the  mayor,  and  subsiMiuontly  of  the  State  Board  of  Health,  was  culled 
to  the  possibility  of  cholera  being  introduced  by  immigrants  during  the  winter  monllis. 

Ne^v  Hampshire  : 

Dr,  Irving  A,  Watson,  Secretary  of  the  New  Hamps^hire  State  Board  of  Health,  writes, 
under  date  of  October !!,  1885:  "Except  under  unusual  liability  to  infection,  no  (luaranline 
is  maintained  at  Portsmouth.  The  only  vessels  that  come  into  the  harbor  of  Portsmouth 
are  coasters  from  American  ports,  and  a  few  vessels  now  and  ihen  from  the  Pritisli 
Provinces  (New  Brunswick  and  Nova  Scotia.)  During  the  present  luontli  but  one  vessel 
lias  entered  the  port  outside  of  coasters  from  American  ports,  untl  that  was  a  vessel  from 
New  Brunswick  loaded  with  railroad  ties.  Tlie  very  small  amount  of  shipping  that  conies 
into  Portsinoutli  outside  of  our  own  coast  trade  which  is  very  small,  consists  of  now  iiinl 
then  a  vessel  loaded  with  railroad  ties  from  the  Provinces,  ami  salt  from  Turk's  island.  Their 
is  no  passenger  tralllc  whatever.  The  ciuarantine  laws  of  the  State,  as  well  ns  the  city 
ordinances  of  Portsmouth,  are  auito  strict,  and  in  the  v(>ry  few  instances  of  contagious 
diseases  that  have  been  found  on  board  of  vessels  coming  into  the  harbor  of  Portsmouth, 
the  niaslersof  such  vessels  have  notided  the  pilots  and  a  medical  olTleer  has  been  sen.; 
to  them  and  suitable  (luaruntine  established, 

"Formerly  there  was  a  (juarantine  station  about  a  mile  down  the  harbor,  whi(ih  was 
established  and  used  exclusively  by  the  government:  it  now  exists  unoccupied.  There  has 
been  no  occasion  for  the  disinfection  of  cargoes,  for  many  yeai's,  I  tliink.  The  govovn- 
ment  li.is  sent  one  or  two  vessels,  among  which  was  the  Plymouth,  up  to  this  port  to 
freeze  out  the  yellow  fever. 

"I  ilo  not  know  of  a  single  instance  In  which  disinfection  of  vessels,  crews  and  cargoes 
lias  been  rcciuired.  I  have  recently  investigated  the  condition  of  alTairs  at  this  port,  and 
do  not  II lid  it  necessary  at  the  present  time  to  establish  a  Quarantine  station.  There  is  not 
the  least  probability  of  small-pox  being  brought  to  Portsmouth  from  Montreal  and  vicinity, 
or  from  the  Provin(>es  by  water.  On  the  other  hand  we  have  no  infected  cities  to  fear  along 
our  own  coast,  and  as  no  v(>ssels  arrive  from  foreign  ports,  other  than  those  mentioned 
above,  there  seems  to  be  no  demand  whatever  for  a  amirantine  service.  Should  any  cir- 
cumstance arise  that  would  make  it  necssary  to  establish  such  a  service  at  Portsmoutli,  wo 
would  do  so." 

Massachusetts: 

In  company  with  Dr.  S.  H.  Durgiii,  Chairman,  and  Mr.  George  F.  Babbitt,  a  member  of 
the  Boston  Board  of  Health,  I  made  a  visit  of  inspection  to  the  Boston  (luarantino  cslal)- 
lishmcMt  on  the  i;Jtli  of  August  last.  This  is  situated  on  Gallop's  island,  about  .seven  miles 
from  "iiM'ity,  a.vi  comprises  abundant  hospital  accommodations  for  contagious  discuses 
in  two  buildings:  a  largi;  storehouse  for  infected  cargoes,  connected  with  deep  watm-  by  a 
suitubh-  wharf  and  tramways;  and  upon  another  wharf  is  a  building  for  disinfecting  I'lolli- 
ing,  baggage,  (>tc.  TJic  island  is  about  twelve  acres  in  extent,  and  vessels  may  lie  at  its 
wharves  entirely  out  of  the  track  of  commerce.  The  arrangement  of  the  buildings,  etc., is 
compact  and  workmanlike,  and  everything  was  found.ingood  order. 


15 


.  '■•<■. 


rooted  atthisplufo; 
itoros  from  vessols 
le  exception  of  thi^ 
lis  is  iirulorthe  .'on- 
ige  station,  incase 

t  possossea  in  this 
ilwtiy,  and  tlnw  ro- 
found  that  inspoc- 
lioy  are  boarded  hy 
ind  on  a  vessel,  it 
ity;  tiiose  on  board 
icticable  under  tlio 

Healtli,  was  called 
10  winter  montlis. 


.  of  Health,  writes, 
tion,  no  (iiiarantine 
rbor  of  Portsmouth 
II  from  the  IVi'itish 
nth  but  one  vessel 
,t  was  a  vessel  from 
hipping  that  conios 
onsists  of  now  and 
'urk's  island.  There 
as  well  as  the  city 
nces  of  contaf;i()us 
)or  of  Portsmouth, 
ficer  lias  been  sen.; 

harbor,  whi(!li  was 
cupicd.  Tliere  has 
hink.  The  govern- 
up  to  this  port  to 

crews  and  (iargoos 
rs  at  this  port,  and 
ition.  There  is  not 
itreal  and  vicinity, 
itles  to  fear  along 
n  those  mentioned 
Should  any  cir- 
at  Portsmouth,  we 


bbitt,  a  member  of 
Iiiarantine  cstab- 
iihotit  seven  miles 
uitagious  diseases 
111  deep  wati'r  by  a 
isinfectiiig  ''lolh- 
sels  may  lie  at  ils 
3  buildings,  etc.,  is 


boarding  station  is  at  Deer  island,  about  a  mile  and  a  half  from  quarantine,  and 
till'  port  physician  resides  at  this  station  during  tl;o  entire  year.  The  (luarontine  steamer, 
Siiinuel  Little,  is  also  kept  at  the  Doer  island  station  ready  for  boarding  vessels,  conveying 
the  sick  from  vessels  to  the  hospitals,  etc.  Since  my  inspection  this  ve8.sel,  built  for  the 
(luarantino  service  thirteen  years  ago,  has  been  ordered  to  b(i  rei.laeod  bv  a  new  one  with 
important  improvements  and  better  facilities  for  disinfection.  The  regulations  require  the 
purl  physician  in  (luarantine  to  visit  and  inspect  all  vessels  arriving  in  the  harbor  between 
.Tune  and  November  from  any  foreign  port,  except  Canada  and  the  Provineos,  and  from 
any  domestic  port  south  of  Virginia.  No  vessel  which  has  had  on  board,  during  her  last 
vdyage,  any  sickness  of  a  contagious  or  doubtful  character,  shall  i)ass  <tuarantin(<  without 
inspection  and  consent »of  the  port  physician.  It  is  also  provided  by  n^gulation  that  no 
vessel  shall  bo  allowed  to  bring  any  sickness  of  a  doubtful  or  contagious  character  past 
iiiianintine  during  any  season  of  the  year.  Every  facility  is  provided  for  the  speedy  and 
Cdiiifortablo  transfer  and  the  subse(iuent  care  of  such  persons  as  nicy  arrive  by  vessels 
siilTering  from  contagious  or  infectious  diseases.  The  itersonnel  of  the  (iiiarantine  estab- 
lislmicnt  consists  of  two  physicians  and  the  necessary  employes.  The  physicians  are  em- 
ployed during  the  whole  year.  When  (iiiarantine  duties  do  not  demand  their  attention  they 
are  occupied  in  the  city  institutions  on  Deer  island. 

In  the  large  storehouse  there  is  an  apartment  for  disinfecting  rags  and  other  articles  by 
the  snliihurouK-acid  process,  and  there"  is  also  a  larg(^  amount  of  storage  eapaidty.  Tho 
(lisiiifcN'tlon  of  clothing,  pi^rsonal  baggage,  etc.,  is  effected  by  the  steam  process.  The 
superhi^ated  steam  is  supplied  by  the  quarantine  steamer.  For  my  observation  tlie  steam 
was  discharged  into  the  apartment  provided  for  this  purposes,  and  in  a  few  minutes  tho 
iiiuperatui'M  was  raised  to  2:20=  1'.,  at  which  point  it  was  evident  it  could  be  maintained  as 
loug  as  desired. 

All  immigrants  are  examined  on  arrival,  and  are  vaccinated  or  reviiccinatedif  notpro- 
ti  ctcd  by  decid(Hlly  recent  vaccination  or  revaccination.  •  Careful  scrutiny  is  bestowed  on 
all  iiersons  and  goods  arriving  by  vessel,  untl  such  cargoes,  vessels  and  personal  baggage 
as  seem  to  retpiire  it  are  thoroughly  disinfected  as  above  indicated. 

The  adminhtration  of  quarantine  at  Boston  has  received  for  the  last  nineteen  years  the 
direct  supervision  of  tho  present  Chairman  of  the  City  Boai-d  of  Hea'tli,  and  tho  access  of 
cholera  through  this  port  is  hardly  likely  to  occur.  Curing  this  period  I  have  been  able  to 
trace  small-pox  cases  to  Boston  very  rarely,  and  none  for  several  years  recently.  Tho 
inclhods  pursued  at  this  port  demonstrate  that  the  disease  may  be  excluded. 

Rhode  Island : 

The  (luarantine  regulations  of  the  port  of  Providence  are  under  control  of  the  board  of 
iililermeii,  who  appoint  annually  a  health  ofTlcer  of  quarantine,  to  execute  such  orders  as 
s:ii(l  board  may,  from  time  to  time,  prescribe  relating  to  (iiiarantine.  Dr.  Charles  V.  Cha- 
liiii.  Superintendent  of  the  Health  Department  of  Providence,  writes  '  'that  all  vessels  sub- 
ject t(>  (Iiiarantine  are  stopped  about  one  mile  below  the  city.  Vessels  are  inspected  by  the 
health  olTlcer  before  they  are  allowed  to  come  to  the  wharf,  or  have  any  communication 
with  the  shore. 

"Our  foreign  commerce  is  very  small,  mostly  with  St.  .lohn,  N.  B.  and  with  the  W<39t 
Iiiilies.    The  only  European  arrivals  wo  have  are  a  few  Italian  ves^sels  with  suli)liur. 

"If  any  vessel  was  found  to  be  infected,  I  would  have  her  thoroughly  cleansed  and  dis- 
iiileeted  with  sulpliur  or  chlorine  or  both.  Baggage  and  clothing  of  crew  could  be  treated 
on  shore  at  the  small-pox  hospital  grounds,  which  are  situated  near  (luarantine.  Our 
eliannel  is  so  narrow  that  it  is  impossible  for  vessels  to  anchor  very  far  from  the  line  of 
travel." 

Connecticut  f 

The  iiuaraiitlne  facilities  of  New  Haven,  the  most  important  Connecticut  port,  aro 
ileseribed  by  Dr.  Liiulsloy,  Secretary  of  the  State  Board  of  Health,  as  "not  entirely  satis- 
factory. No  special  preimrat ion  exists  for  the  proper  management  of  vessels  subject  to 
miiirautine,  exceiiting  that  th;'  Board  of  Health  of  Now  Haven  Is  clothed  with  full  authori- 
ty. t(i  subject  any  s-ch  vessel  to  such  regulations  for  the  protection  of  New  Haven, as  said 
lii'Mfd  may  deem  uoeossary. 


16 


\'k^\    ■   I' 


>  \y 


)i :  i' 


.:.^S-t 


■;^':'^  (■'!',•' 


"The  veflHol  (and  cargo,  if noocfSHiiry.)  would  bo  dislnffcted  by  tho  funics  of  burning  sul- 
phur and  Hiibs('(iiiont  ventilation,  and  waHhiiiKwith  Holutioii  of  corrosive  Hii))liinate  orsoini' 
of  tho  iireparatlniis  of  chlorino.  The  elothiiiK  of  tho  (S'uw  and  their  perwonal  elToctH  would 
ijo  also  dihinfectod,  and  tlxiy  would  bo  kopt  undor  suporvlsion  until  danger  of  comnninicii- 
tion  of  the  disease  had  passed. 

"Vessels  on  whieli  thfjre  has  been  uo  malignant  or  eontagious  disoaso  during  the  voy. 
a;,'e,  and  on  which  then!  is  at  i)resi)nt  no  siokniiss  may  come  to  any  |)ul)li(^  wharf  in  N(!\v 
Haven  harbor,  and  signal  for  tho  health  ofllct>r;  but  no  person  is  allowed  to  leave  the  vi'ssol 
beforethe  arrival  of  tho  health  ofTl(!er.  In  ease  of  any  8i(;kness  on  board,  the  vessel  hIiuII 
come  to  ani'hor  within  (luarantine  limits  and  signal  for  tho  lioaUh  olTlcer  from  there.  Tiii> 
nuarantino  station,  as  you  will  see'by  tho  enclosed  map,  is  oiUy  one  and  one-halt  niiii's 
from  the  centre  of  tho  city,  and  in  Now  Haven  harbor  directly  in  tho  line  of  travel. 

"In  case  of  tho  arrival  of  a  cholera  vessel,  it  would  be  det.iiimd  in  iiuarantine.  Tln'ic 
is  no  hospital  provided  for  the  reception  of  cholera.  Th(>  patient  would  bo  kei)t  on  bounl 
under  siK^h  care  as  was  pra(^tlcal)le,  rospocting  isolation  ami  disinfection,  until  a  temiior- 
ary  provision  could  bo  made,  (by  tents,  probably,)  on  the  shore  for  his  or  their  reception, 
after  which  the  vessel  would  bo  disinfected.  If  the  cargo  was  such  as  to  reiiuire  si>ecinl 
apparatus  for  disinfecting  it,  we '.have  none,  and  shculd  have  to  send  the  vessel  to  Now 
York  or  elsewhere  for  that  purpose." 

.New  York: 

About  two-thirds  of  the  total  immigration  and  more  than  two-thirds  of  the  total  foreign 
imports  into  the  United  States  pass  through  iiuarantine  at  the  port  of  New  York.  Witliout 
assuming  that  these  proportions  may  bo  taken  as  a  nieasure  of  the  relative  importance  of 
tho  Now  York  (luarantine  compared  with  the  (luarantines  of  the  rest  of  the  country,  itt 
absolute  importance  cannot  be  overestimated.  The  individuwls  and  their  elTocts  ami  the 
cargoes  with  which  it  deals,  are  distributed  to  every  part  of  the  continent,  and  while  fidni 
climatic  and  other  (conditions,  the  port  itself  might  be  protected  by  given  (luarantfne 
methods,  it  would  by  no  means  follow  that  measures  adequate  for  such  protection  would 
ensure  the  safety  of  remote  sections  of  the  country  from  the  disastrous  etTeets  of  the  im- 
portation of  foridgn  contagion  or  infection  through  and  beyond  tho  port.  Many  improve- 
ments in  tlu!  Now  York  (luarantine  system  have  been  made  during  tho  past  twelve  or 
lltteon  years,  and  to  a  great  extent  in  direct  recognition  of  those  considerations.  Duiinn 
this  period  the  interest  of  tho  int(>rior  in  the  administration  of  the  system  has  come  to  be 
acknowledged  and  is  allowed  to  i^xort  some  influence. 

Tho  statutes  relating  to  (iiuirantine  at  the  port  of  Now  Y'ork  are  very  voluminous,  Imt 
the  most  imi>ortant  are  to  bo  found  in  Chapter  358  of  tho  Laws  of  18(i;{,  entitled,  "An  n<-t 
establishing  a  (luarantine  and  dollning  the  (lualillcations,  duties  and  powers  of  tho  health 
ofificer  for  tho  harbor  and  port  of  Now  York, "  and  in  Cliapter  592  of  the  Laws  of  18(i5,  amend- 
atory thereof.  Although  there  is  a  board  of  iiuarantine  commissioners  consisting  of  tlinc 
members,  tho  powers  and  duties  prescribed  by  tho  law  are  practically  exerted  and  dis- 
charged by  the  health  olTlcer  aforesaid.  In  1880,  upon  the  establishment  of  a  State  Uoard 
of  Health,  this  olllccr,  together  with  th(>  attorney-general  and  the  superintendent  of  the 
State  survey,  were  made  i^.r-officio  members  of  the  State  Board,  but  no  control  or  autluu-ily 
over  maritime  iiuarantine  is  confei-red  upon  or  exercised  by  the  Board,  except  indirectly 
through  the  cx-offirio  connection  of  the  h(>altli  oniecr,  who  is  chairman  of  a  standing  coni- 
miltoc  of  that  body  ui>on  the  sul)ject  of  (luarantino. 

On  tho  10th,  nth  and  12th  of  August,  in  company  with  Di.  William  M.  Smith,  Health 
Onicer  of  tho  Port,  I  made  a  personal  inspection  of  the  iiuarantine  establishment  and  of  the 
methods  enforced  thereat.  TluMiuarantine  anchoragii  is  in  the  Lower  Bay,  a  trlanguliu' 
area  of  about  two  and  one-half  miles  along  its  sides,  its  northern  apex  being  about  ek'ven 
miles  from  the  city  and  Ave  miles  f"  ni  tho  health  officer's  station,  near  Clifton,  on  the  left 
shore  of  "  the  Narrows."  At  the  upper  apex  of  the  anchorofi^o,  and  about  four  miles  in- 
side of  Sandy  Hook,  is  moored  the  quarantine  ship,  "Illinois,"  in  charge  of  a  dcpiity 
inspector. 

After  the  first  day  of  May  and  until  the  first  of  the  ensuing  November,  all  vessels 
from  the  West  Indies,  tho  Windward  Isles,  tho  oast  coast  of  South  America,  and  the  west 


I? 


17 


<f. 


imcs  of  biirniiiK-iil- 

0  sublimate  or  sonn' 
•Honal  ofTocts  Wdiiki 
iiBcr  of  ('oiniiiiiiiicii- 

ii8o  (UiriiiK  tlie  voy- 
iil)lii'  wharf  in  N(;\v 
li  toloiivc  tlie  vcHsel 
rd,  tlid  vossi'l  Himll 
n-  from  tlioro.  The 
unci  onc-luilf  niiii', 
10  of  travel, 
(luarantino.    Tiicre 

1  be  kept  on  boui'ii 

on,  until  a  tcniiior- 

or  their  reception, 

to  require  spccinl 

i  tlie  vessel  to  New 


I  of  the  total  foroinn 
few  York.  VVitlioiit 
itive  iniportanoo  of 

of  the  country,  itt 
lieir  effects  and  tlic 
out,  and  while  from 
y  given  (luarantfno 
ih  protection  would 
IS  effects  of  the  ira- 
rt.    Many  iniprovi'- 

the  past  twelve  or 
idorations,  Diirinj,' 
em  has  come  to  be 

ry  voluminous,  Imi 
i,  entitled,  "An  art 
)wers  of  the  ln'alth 
iws  of  18(15,  anii'iiil- 
consistins  of  tlirci' 
exerted  and  dis- 
t  of  a  State  liojiid 
)erintendent  of  the 
ontrol  or  authority 
,  except  indiri'i'tly 
)f  a  standing  i-om- 

M.  Smith,  Hcaltli 
ishniont  and  of  tin' 
■  Hay,  atrianf:iilar 
beiuK  about  elevi'ii 
Clifton,  on  the  left 
out  four  miles  iii- 
large  of  a  di'inity 

jmber,  all  vessels 
rica,  and  the  west 


cuiist  of  Africa,  as  also  those  from  infected  ports  of  the  United  States,  are  brought  to  an 
anchor  ntMir  tlds  veHS<>l  and  board(>d  t)y  an  inspector  from  an  ordinary  row  boat.  The 
ollli'or  aHcertains--lKt.  The  present  condition  of  the  passengers  and  crew.  Ud.  Tlie  his- 
tory of  tiio  vessel  during  the  passage  in  reference  to  sicknes.n,  etc.,  and  the  sanitary  his- 
tory of  the  viissel  whih^  in  the  port  of  departure.  The  bill  of  health  is  tlien  (\\andn;od,  and 
till' sworn  statement  of  the  (tnptain  and  medical  odlcor  of  the  vessel  is  next  required,  each 
l)('lng  duly  sworn,  that  the  port  or  ports  from  widch  they  sailed  were,  to  the  best  of  their 
kimwlcdge  and  belief,  perfiictly  iiiwilthy,  being  fret!  from  all  malignant  contagious  and 
iiil'ritious  disease;  that  no  such  disease  existed  among  tlie  shi|)ping  in  said  port  or  ports 
at  tic  time  of  their  departure,  and  that  no  case  ol  sickness  or  deatli  from  small-pox,  ciiol- 
(M'a,  yellow  fever,  ship  fever,  or  any  contagious  or  Infectious  disease!  has  occurred  on 
lioard  thii^r  vessel  while  in  any  port  or  on  the  passage. 

A  .arofiil  examination  is  made  in  every  instance  of  the  8tt!erage,  and  if  objectionable 
from  filth,  it  is  ordered  to  be  immediately  cleansed  and  then  fumigated.  If  the  vessel  has 
been  absent  from  the  fiort  of  departure  for  a  time,  etiual  to  or  exceeding  the  usual  period 
of  im-iibation  of  the  disease  prevailing  at  su<di  port,  the  passengers  are  inspected  by  the 
iiuaraiitine  officer  and  the  vessel  is  discharged  under  a  per... it. 

If  there  is  any  sickness  of  a  suspicious  character  resembling  yellow  fever,  cholera  or 
typhus,  the  sick  are  removed  to  the  (|uarantine  hospital  on  Dix  island.  If  the  ship  is  less 
than  ilve  days  from  a  port  infected  with  yellow-fever,  passengers  and  vessel  are  held  until 
that  period  has  fully  elapsed.  In  the  meantime^  the  hatches  are  opened,  the  cargo  and 
steerage  are  fumigated  twice,  at  various  intervals  of  several  hours,  with  chlorine  or 
sulphurous-acid  gas. 

All  baggage,  mails,  and  whatever  articles  liable  to  have  become  infected  are  put  in  a 
I'losc  apartment  and  submitted  to  disinfection  by  the  agents  mentioned.  This  done,  the 
master  of  the  vtissel  is  given  a  '  'permit"  and  directed  to  the  discharging  anchorage  in  the 
upper  l)ay,  distant  three  miles  from  the  city.  Hero  (in  the  language  of  Dr.  Smith's  report,) 
under  the  constant  supervision  of  the  <iuarantine  police,  and  the  fretiuent  visitation  of  the 
licaltli  officer,  the  most  perfect  system  of  cleanliness  is  enforced.  In  the  meantime  the 
i.UKo  is  discharged  upon  open  lighters.  The  exposure  of  the  cargo  to  idr  in  lis  transit 
toliicdock,  serves  still  further  to  reniovo  the  danger  of  infection.  There  is  no  inst-vnce 
of  the  propagation  of  disease  from  that  source  in  the  history  of  (luarantino  at  the  port 
of  New  York.  The  (sargo  being  removed,  the  hold  is  thoroughly  washed,  and  in  tlie  case 
of  sailing  ve8S(!ls  the  limber-streaks  alon^  the  keelson  are  taken  up,  accumulations 
of  llltli  removed,  and  the  air-spaces  washed  down,  until  the  water  returns  clear  ( f  any 
eyidence  of  impurity.  A  solution  of  sulphate  of  iron,  or  of  bichloride  of  mercury  is  then 
used,  with  wiiiidi  to  scrub  and  rins(!  the  entire  hold,  inclusive  of  the  air-spaces  and  limber 
streaks.  Finally,  from  fifty  to  one  luindr(!d  pounds  of  sulphur,  according  to  the  size  of 
ilie|vesscl,  are  burned  under  tlie  hatches,  which  are  closely  cover(!d.  Th(!  ship's  crew 
is  tlien  mustered,  and  examined  as  they  pass  before  the  health  officer.  If  all  are  well  the 
vesselis  allowed  to  proceed  to  her  dock  .without  further  delay.  In  vessels  suspeeted  of 
yellow-fever  inlection,  tlie  crew  are  not  allowed  to  discharge  cargo,  or  if  they  do,  are 
submitted  to  a  quarantine  of  observation  for  live  or  six  days. 

All  foreign  vessels  not  suDject  to  visitation  in  the  lower  bay  afe  boarded  by  the  health 
oflleer  or  his  deputy  at  the  Ijoarding  station  on  Staten  Island,  a  short  distani.'e  al)Ove  the 
Niirro\ys,  and  opposite  the  health  ofTlcer's  residence.  From  May  until  November  follow- 
ing, all  vessels  from  ports  "south  of  Capo  Henlopen, "  are  visited  at  this  point,  unless 
some  of  the  ports  south  of  this,  become  infected  with  yellow-fever,  in  which  case  vos-sels 
from  such  i)orts  are  examined  at  the  (luarantine  station  in  the  lower  bay. 

The  ipuirantine  hospital  for  yellow  fever  and  other  contagious  diseases,  except  small- 
fiox,  is  upon  Dix  Island,  an  artificial  cunstruotion  about  two  miles  above!  the  quarantine 
an.liorngc  towards  the  Staten  Island  shore,  out  of  the  track  of  commerce.  The  hospital 
is  built  on  the  fiavllion  plan,  has  five  wards  connected  by  covered  passage-ways,  and  has 
eomfortable  accommodations  for  300  patients.  There  are  also  on  the  island  suitable  (luar- 
ters  fur  officers  and  attendants,  a  disinfecting  room  and  all  the  modern  sanitary  appli- 
ances. Bmull-pox  cases  are  not  treated  here,  but  are  taken  to  one  ot  the  city  institutions 
on  Blackwell's  Island  in  the  East  River. 

—2 


IIP- 


r 


■■•I' 


18 


r/.i 


m   ■ 


'  4  >  - 

■'ii;'''  'I'Tri  ■ 


■  k  ■ 


One  mill-  iibovo  Dlx  IsUiiid  is  Hoffiniiii  Islund,  alno  iirfiflclal.  iind  u|)oii  thiH  are  tho 
buildings  and  applianetw  ni'COHsary  for  a  tiuiirautini;  of  observation.  '  'duspocta"  from  j-iij. 
low-fiivcr,  (du)l(M'a,  typliUH  or  yidlow-fever  i)x|)osuro,  am  Imro  dotainod  during  tliu  ruspuc. 
tivc  periods  of  intubation.  Two  imracMi.so  structures  furnisli  acconmiodations  for  iibout 
2,000  persouH,  and  in  aiiotlior  building  an)  tho  (piarlors  for  olTliiers  and  employiis,  an  I  for 
administration  purposos.  Abundont  batliing  and  laundry  facllitios  and  disinfecting  appll- 
hnccs  aid  provided,  and  hero  as  well  as  on  Dlx  Island,  are  immense  reservoirs  iiiul  a 
number  of  clHterns  for  the  storage  of  fresh  water. 

Tho  health  odicer's  station,  or  main  auarantine  station  is  near  Clifton,  and  at  tliib 
place  is  the  residence  of  the  health  ofllc(>r,  quarters  for  two  deputies,  and  a  good  wharf. 
Vessels  are  here  boarded  from  a  commodious  steam  yacht,  by  which,  also,  conimiinimi- 
tion  with  the  olher  divisions  of  tlic  (juarantine  establishment  is  miiintained.  The  islandH 
and  stations  are  connected  by  telegraph,  ami  the  liealth  olllcer's  (luarters  are  also  con- 
nected by  wire  with  the  city. 

The  personnel  of  tlie  establishment  Viiries  with  the  exigencies  of  the  season.  In  addi- 
tion to  the  health  ofiioer,  I  found  oidy  two  deputies  emi'loyed,  one  upon  tho  iiiiiUMnline 
ship  and  one  at  the  (luurantine  station.  Dr.  Smith  himself  attends  to  tho  siclt  in  hospital, 
and  was  treating  a  yellow-fever  case  (convalesctuitj  during  my  visit. 

Bumming  up,  Willi  reference  to  the  exclusion  of  chohu-a  iind  small-pox,*  the  iiuiirin- 
tino  plant  and  facilities  of  the  port  of  New  York  art!  unrivalleil.  the  printed  regulntlons 
judicious,  und  with  proper  vigilance,  the  service  should  sulllce  to  prevent  either  of  tlieso 
diseases  from  (obtaining  access  to  the  country  through  this  avenue.  JJuttlni  entire  sys- 
tem is  liampered  by  a  vicious  lliiaiu'ial  policy  which  is,  in  elTect,  a  farming-out  of  the  ser- 
vice. At  tho  other  important  ports  the  fees  go  directly  to  the  municipality  or  State,  findthf 
chief  executive  olllcers  are  paid  Ilxed  salaries,  and  are  provided  with  such  employs  n;* 
may  be  noi'essary  to  the  proper  and  etHcient  conduct  of  tht'  (luarniitine. 

New  Yorlv  may  exclude  cholera  liuder  her  present  system,  Imt  more  conlldenco  would  br 
reposed  in  tho  result  if  loss  wore  demanded  of  professional  ability,  personal  integrity  ami 
executive  firmness  in  he  health  ofllcer,  and  if  the  system  were  freed  from  in(luenc(^s  whidi 
are  most  deprecated  liy  those  who,  without  prejudice,  best  understand  thorn. 

Pennsylvania: 

The  maritime  quarantine  of  tho  port  of  Pliiladelphia,  and  practically  of  tho  State  of 
Pennsylvania,  is  enforced  at  the  '  'Lazaretto",  situated  on  the  left  bank  of  tho  Delawan.' 
river,  about  eleven  miles  bolow  Philadelphia  In  company  with  Dr.  R.  A.  Cleemnnn,  of 
the  City  Board  of  Health,  and  Dr.  Benjamin  Lee,  Secretary  of  the  State  Board  of  Health, 
I  made  a  visit  of  inspection  to  this  station  on  the  (iih  of  August  last.  The  quarantim' 
grounds  are  about  ten  acres  in  extent,  surrounded  by  cultivated  farms  and  separated  from 
the  main  channel  by  Little  Tinicum  island,  between  which  island  and  the  station  there 
was  formerly  a  navigable  channel  which  was  used  as  the  quarantine  anchorage,  but  is  now 
too  shallow  for  that  purpose  for  largo  vessels.  Quarantine  was  established  at  this  point 
in  the  early  part  of  the  century,  and  .sections  of  a  law  enacted  in  1802  are  still  in  force. 
There  has  boon  practically  littlo  change  in  tlio  equipments  or  methods  since  1818,  exeept 
that  a  steamboat  has  replaced  tho  many-oared  barge  used  formerly  in  visiting,  and  that 
by  this  means  vessels  are  inspected  en  route,  not  being  obliged  to  come  to  anclior  unless 
detention  for  sickness  is  necessary.  The  structures,  comprising  a  largo  hospital  (sixty 
bods),  administration  building, government  warehouses,  etc.,  arc  well  built  and  spacious,  ' 
but  anti(iiiatod.  For  more  than  half  a  century  the  establishment  was  tho  best  e(iuipped 
on  the  continent.  All  vessels  from  foreign  ports  and  such  American  ports  as  maybe 
designated  by  tho  Board  of  Health  of  Philadelphia,  bound  for  the  iiort  of  Philadclpliiii, 
and  arriving  between  tlio  lirst  of  June  and  the  first  of  October,  are  required  to  come  fn 
anchor  as  near  the  Lazaretto  as  the  draft  of  water  will  permit,  and  there  await  the 
visit  of  the  (luarantino  olllcers,— the  Lazaretto  physician  and  tho  quarantiniMiiastor, 
The  former  administers  the  oath  or  anirmation  to  the  caiitain,  ami  examines  persdiiallv 

*  Cholera  found  its  way  through  ihN  port  to  the  eastern  portion  of  this  ooiititry  in  1^1". 
and  to  tlie  country  generally  in  ISti.j.  No  attention  is  paid  to  tlie  vaccinal  status  of  immi- 
grants unless  the  d.sease  is  actually  on  vessels.  As  a  natural  consequence  small-pox  has 
repeatedly  been  introduced  into  tho  interior  through  this  port. 


19 


1(1  111)011  this  are  tho 
"Suspocta"  from  ycl- 
3d  during  tliu  rospiic- 
iiiodiUions  for  about 
111  employes,  mi  I  for 
nd  disiiifoc'tinK  iippll- 
OHO  reservoirs  juul  a 

Clirton,  and  iit  tliib 
B,  and  a,  good  wiiarf. 
di,  iiiso,  conimiiiiii'ii- 
It  (lined.  Tlie  ishiiidH 
unrtors  are  also  coii- 

tlio  season.  In  iiddi- 
upon  tlio  iiuiir.intini' 
I  the  bielc  in  hospital, 

ill-pox,*  the  iiiiJH'in- 
printed  roHuliitions 
■event  either  of  these 
liiit  tlie  entire  sys- 
rniing-out  of  tlie  ser- 
iility  or  State,  aiul  the 
ith  onch  employs  a« 
I  no. 

<j  conlhleneo  would  lie 
lersonal  integrity  iiiul 
!rom  induenceswhicli 
id  them. 

tically  of  tlie  State  of 

janli  of  the  Delaware 

R.  A.  Cloemann,  of 

tato  Board  of  Health, 

last.    Tlio  quarantine 

IS  and  separated  from 

md  the  station  there 

imoliorage,  hut  is  now 

[ibiished  at  tliis  point 

802  are  still  in  force, 

xls  since  181S,  exeept 

in  visiting,  and  that 

:)nio  to  anchor  unloFS 

largo  hospital  (sixty 

1  Ijtiilt  and  spacious,  ' 

IS  the  best  e(iuipped 

in  ports  as  may  be 

ort  of  Philadelpliiii, 

reiiuired  to  come  to 

and  there  await  the 

10  (luarantine  master, 

examines  persunallv 

f  this  country  in  I'il". 
ciiial  status  of  immi- 
uonco  small-pox  has 


into  tli(»  state  of  health  of  all  on  board,  and,  in  eonjunetion  with  the  iiuarantine  master, 
jisecrtalns  the  sanitary  history  of  tlie  voyage, liondition  of  port  of  departure,  character  of 
eari:e.  etc  The  latter  ofTlcer  e.xamlnes  Into  the  eondltion.  with  regard  to  cleanlinijss, 
.,f  the  hold,  cabin  and  foreeastlo,  c  lines  the  bilge  to  bo  pumped  out  and  purified  by  fresh 
water,  and  ascertains  wln^ther  any  part  of  the  cargo  Is  in  a  damaged  or  lnfi;etlous  ctmdl- 
lion.  It  the  vessel  Is  satisfactory  In  all  these  resiiects,  a  certilleate  to  that  effect,  signed* 
liy  both  olTl.v^rs,  Is  furnished  and  she  is  allowed  to  proceed  to  the  port.  This  certificate  is 
aihlie-sed  to  the  health  (jflleer  of  the  port,  to  whom  It  must  be  delivered  within  'Jl  hours 
alter  the  vessel  lands  at  her  wharf. 

If  any  contagious  or  Infectious  disease  (measles  excepted)  bo  found  on  board,  or  If  the 
vi,s-r|  he  from  nn  infected  port,  or  If  her  cargo  be  considered  dangerous  as  to  contagion 
orinfi'CtioiKor  the  veFsol's  sanitary  condition  be  unsatisfactory,  die  certilleate  is  withheld 
iiiiil  tlie  necessary  measures  are  Instituted  to  ren'ler  her  safe  from  conveying  contagion  or 
infi'dion.  These  measures  are  entirely  within  the  discretion  of  the  I.azare''/>  physician* 
(of  eourse  under  the  control  of  the  Board  of  Health  of  the  City)  and  are  eniorced  under 
his  supervision  by  the  quarantine-master.  So  far  as  they  are  prescribed  they  consist  of 
rmrineation  "by  ventilation,  scrubbing  and  whitewashing."  Fumigation  is  efTectod  by 
-ulihiir  combustion  in  iron  iiots.  There  are  none  of  the  modern  appliances  for  disinfec- 
tiouof  vessels  or  cargo.  \o  attention  Is  paid  to  the  vaccinal  status  of  Immigrants  unless 
?niall-pox  is  discovered  on  a  vessel;  and  as  a  natural  consequence  the  disease  has  fre- 
quently been  Introduced  into  the  interior  through  this  port.  Telegraphic  communication 
hasreeiMitly  been  established  with  Philadelphia. 

Owing  to  the  filling  up  of  the  channel  in  front  of  this  Lazaretto,  large  vessels  detained 
in  iptarantine  could  not  be  kept  out  of  the  track  of  commerce  as  completely  as  Is  desir- 
iilili'.  In  examining  the  surroundings  of  the  station  we  proceeded  on  the  quarantine 
steamer  as  far  south  as  Chester,  at  which  place  we  found  the  revenue  cutter  troni  which 
inspections  of  vessels  arriving  in  tho  Delaware  Bay  are  made.  In  connection  with  these 
inspections  I  took  ocea-^ion  to  repeat  tho  suggestion  made  at  Baltimore,  to-wit:  That  tho 
Government  inspection  service  should  be  utilized  as  fully  as  possible,  and  to  this  end 
should  receive  the  cooperation  and  recognition  not  only  of  Pennsylvania,  but  of  the  Dela- 
ware and  Now  Jersey  health  authorities.  Stale  and  local.  This  sugirostion  was  subse- 
'luently  acted  upon  by  the  adoption  of  a  resolution  by  the  Philadelphia  board  of  health 
reipiiring  all  vessels  from  infected  ports  to  report  for  tho  removal  of  sick  sailors  at  the 
U.  S.  (,)uarai.tlne  Station  at  tho  Delaware  breakwater  before  proceeding  up  the  river. 

Dr  IJeiijamin  Lee,  of  the  State  Board  of  Health,  wrote  me  on  the  l!8th  of  September  that 
"in  company  with  Drs.  Cloemann  and  Ford  and  several  non-professlonnl  members  of  the 
city  beard,  Dr.  Wilson  the  Lazaretto  physician,  and  Dr.  Bailhache  of  the  Marino  Hospital 
service  and  National  Board  of  Health,  I  visited  the  U.  8.  Quarantine  Station  at  tho  Dela- 
ware breakwater  on  S(>ptombcr  4.'  Dr.  Marshall  of  the  Delaware  State  Board  joined  us  on 
the  way.  Dr.  Hunt  of  tho  New  Jersey  Board  fully  expected  to  come  but  was  prevented 
by  an  outbreak  of  typhoid  somewhere  in  his  bailiwick."  After  describing  the  accommo- 
dations, surroundings,  etc.,  and  means  of  boarding  vessels,  Dr.  Leo  adds:  "Tl\,e  vessels 
lie  about  four  miles  off  In  very  rough  water  and  de(  lino  to  come  insido  the  breakwater  on 
aceount  of  tho  time  which  It  takes.  The  only  boat  is  a  little  yawl  entirely  unfit  for  heavy 
weather.  There  is  space  enough  to  put  up  temporary  barracks  here  in  case  of  emergency, 
and  there  is  a  government  pier  close  by  to  which  vessels  could  bo  brought.  There  are  no 
anangements  for  disinfecting  cargoes  or  clothing. 

"It  is  doubtful  whether  this  would  be  tho  best  place  for  a  permanent  quarantine  station 
on  account  of  the  exposed  situation  and  roughness  of  tho  water.  Also  because  incase 
of  storm  so  many  vessels  take  refuge  hero,  often  close  together.  The  distance  from  tho 
city  Is  also  a  possible  objection.  l?l  I  think  there  must  be  an  island  higher  up  the  bay 
fomewhcre,  which  could  be  utilized  for  the  purpose." 


'  Appointed  by  the  Governor. 


20 


m  ^ 


*i 


,»    r ' 


t-  1 


<  ,    t  '' 


'oiiH  of  tho  cDftsting 
':\vii,ter.  deHi.Tibed 


Delaware : 

Quiinuitiiii!  iiloiiK  tlu!  Doliiwari)  (ioiwt  in  liinitod  to  tlio  lociil  roK"' 
trado.    TlKno  is  II  KovDrnnii'iit  (iiiarantino  Htation  at  tho  Dt^lawaro 
in  oonnootloii  with  tho  I'onnHylvariia  <iuurantlno  systom. 

Maryland : 

Oil  till)  Itli  of  AuKUHt,  accomiianiod  by  Dr.  JiiinoH  A.  Bteimrt,  Hoalih  (JommisHioiici',  [ 
iniulo  an  inspuction  of  tlus  (luiinintiiio  ostalilishmoiit  at  the  port  of  Biiitimore.  Thin  in  sit- 
uatod  at  Littlo  Hawkins  or  LuadinK  Point,  about  hovon  miloH  from  tho  oity.ontho  I'alupsco 
rivor.  Tho  jjroiindH  bolonBing  to  tlio  Htation  oinbraco  about  twonty-flvo  aoios,  Hurroundoil 
by  improvod  farms.  Tiiorn  is  a  now  and  woll  arrauKod  hospital  IxiiidiuK  witli  iiccoinnio- 
datlons  tor  forty  patients.  Also  a  rosidonoo  for  tlio  physioian  in  (!liarji;o,  boatmon's  \\oum\ 
stables,  ate,  all  in  jjood  condition  and  neatly  kept.  The  station  is  connoctod  by  tol(,'piione 
with  tho  city.  Tlioro  is  no  provision  for  tho  care  of  those  detained  for  observatifni  after 
exposure  upon  an  infected  vessel.  Tho  hosiiital  facilities  may  be  increased  by  the  use  of 
tents  in  suitable  weather,  and  in  case  of  emerKency  the  old  (luarantino  establishment  now 
used  as  a  sinall-pox  hospital  might  bo  utilized. 

Tho  auarantino  soiison  extends  from  May  1  to  October  31,  and  durinsr  this  period  iin 
assistant  resident  physician  is  on  duty  at  tho  station.  All  foroien  vessels  bringing  pusson- 
gers  are  roiiuired  to  stop  for  examination  throughout  the  year.  No  attention  Is  paid  to  the 
vaccinal  protection  of  immigrants,  unless  small-pox  is  discovorod  on  a  vessel,  and  owing 
to  this  neglect  repeated  Introductions  of  tho  disease  Into  tho  interior  have  ucourred 
through  this  port.  Vessels  are  boarded  in  the  harbor  from  a  steam  tug  kept  in  constant 
readiness  for  that  purpose.  Tho  depth  of  water  at  tho  (luarantine  anchorage  is  about 
twenty-two  feet  at  low  tide,  and  there  is  plenty  of  room  to  anchor  vessels  out  of  tlio  track 
of  commerce.  There  are  no  facilities  as  yet  provided  for  the  dischnrgo  and  disinfwction  of 
cargo  from  an  infected  vessel,  but  additional  facilities  and  proper  appliances  for  disinfec- 
tion are  contemplated. 

As  a  further  precaution  in  the  present  emergency,  I  suggested  the  advisability  of  n- 
quiring  vessels  to  submit  to  inspection  by  the  government  service  at  Capo  Charles. 

Virginia : 

Dr.  .Tames  D.  Gait,  the  Quarantine  Medical  Officer  of  the  Elizabeth  river  district,  lias 
furnished  the  following  from  Norfolk,  under  date  October  20, 1885: 

"In  reply  to  your  in(inirios  as  made  in  letter  No.  20,519, 1  would  brloriy  state  that  the 
(luarantine  facllUie.s  of  this  port  are  ample.  Situated  on  the  Elizabeth  rivor,  itself  an 
estuary  of  Hampton  Roads,  there  is  all  the  sea  room  necessary  for  an  efficient  iiuarantine. 
The  'lua'-antinc  station  is  abreast  of  Carey  Island,  five  miles  below  the  city,  where  therivur 
rapidly  widens  Into  Hampton  Roads.  Vessels  arc  invariably  examined  at  the  station,  and 
are  absolutely  prohibited  from  coming  up  until  inspected  by  the  (luarantine  oftlcers. 

"There  is  nothing  special  about  our  method  of  disinfecting  vessels,  cargoes  and  tiie 
crew.     The  fumes  of  burning  Siulphur  are  usually  employed.     Sometimes,  in  the  case  of 
largo  sized  vessels,  chlorine,  generated  by  the  action  of  sulphuric  acid  upon  common  salt 
is  also  employed  below  the  wator  line.     Vessels  in  quarantine  are  anchored  at  u  safe  dis- 
tance outside  the  main  ship  channel. 

"So  far  I  have  hud  no  cholera-infected  vessels  to  inspect.  Should  any  such  arrive,! 
would  treat  them  on  tho  same  general  principles  of  disinfection  as  other  vessels,  giving 
special  attention  to  tbe  tliorough  dibinfection,  or  destruction,  if  necessary,  of  all  clothing', 
bedding,  rags,  or  any  other  materials  which  might  act  as  fomites  for  the  infection." 

In  response  to  a  subseciuent  in(iuiry,  asking  what  assistance  or  protection  has  been 
afforded  by  the  quarantine  or  inspection  maintained  by  the  National  Government  through 
the  Marine  Hospital  and  Revenue  Marine  services.  Dr.  Gait  writes  that  "while  it  does  not 
relieve  me  from  responsibility  as  the  local  quarantine  officer.  It  is  undoubtedly  an  addi- 
tional protection  to  this  city,  and  I  would  compare  it  in  military  phrase  to  a  second  line  of 
entrenchments  around  us.  This  service  is,  as  you  know,  maintained  only  during  the 
warmer  months,  and  was  raised  on  the  luth  inst.  [Nov.]  for  the  winter,  so  that  I  am  now 
without,  its  assistance." 


21 


f  »f 


'onH  of  the  (Miastinu 
'•.wii.tor.  (lest'ril)«d 


alili  ComiuisHioiicr,  I 
altimoro.  TliU  i^^  !(it- 
(  city, ontlio  I'liliipsco 
Ivn  a<!ro8,  Hurr(iun(li;il 
IdinK  with  accommo- 
Ijc,  boatmon'M  lioii.-ic, 
iniiMct<!d  by  toicphune 
for  observation  aJter 
jreasod  by  tlio  uhc  of 
no  ostal)liHliment  now 

during  this  period  iin 
ssols  bringing  iiusHiin- 
attontion  Ispaidtotlie 
in  a  VO880I,  and  owing 
itorior  have  occurred 
III  tug  kept  in  constant 

0  anchorage  is  about 
ossela  out  of  the  tracli 
i-go  and  disinfwction  of 
ppliances  for  dlsinfec 

the  advisability  of  k- 
it  Capo  Charles. 

beth  river  district,  has 

1  brit'ily  state  that  the 
zabeth  rivor,  itself  an 
m  effleiont  iiuarantine. 
he  city,  where  the  rivOT 
ined  at  the  station, and 

irantine  oflloers. 
ssels,  cargoes  and  the 
niotimes,  in  the  case  of 
id  upon  common  sail 
anchored  at  a  safe  dis- 

Duld  any  such  arrive,  I 
3  other  vessels,  !,'lviiig 
essary,  of  all  clothin*.', 
jr  the  infection." 
)r  protection  lias  been 
il  Government  through 
that  "while  it  does  not 
undoubtedly  an  addi- 
rase  to  a  second  line  of 
aincd  only  durlDK  the 
inter,  so  that  I  am  now 


Huli-'Ciiiientlv.  Doc.  31,th<>  following  information  was  furnished  through  Dr.  Qnlt  'ly 
Dr.  1'.  M  Uniuahart,  of  the  Marine  Hospital  servlco:  "The  service  has  two  auivrantine 
^team<Ms,  the  Woodworth  and  Manhattan,  which  aro  used  for  inspecting  vessels.  If  any 
ve'<»t'l  is  found  infecteil  it  is  carried  to  Fishornuin's  Island  and  Muarantined,  and  tht)  side 
pittCrtd  in  hospital  on  the  Island.  The  hospital  was  built  during  the  summer  ol  1884,  and 
contains  about  twenty  beds. 

"Fi-lierman's  Island  Is  just  ofT  Cape  Charles.  A  keeper  and  assistant  remain  at  the 
ho^pital  at  all  times,  and  extra  help  Is  employed  In  case  of  sickness.  Two  surgeons  of  the 
Marine  Hospital  service  aroidotailed  for  the  summer  season  (May  to  December),  the  one  In 
charu't',  tlio  other  as  assistant.  Tlio  vessels  inspected  an^  all  foreign  vessels  and  vessels 
from  the  southern  ports  of  the  United  States.  Every  vessel  is  thoroughly  inspected  (each 
man  Inspected  and  cargo  examined).  If  vessel  is  found  Infected,  cargo  is  transferred  to 
lighters  and  thoroughly  disinfected  (or  thrown  overboard),  and  vessel  thoroughly  cleansed, 
(li»lnfe>  led  and  detained  In  auarantino  for  a  certain  length  of  time." 

North  Carolina: 

There  are  four  ports  of  entry  on  the  North  Carolina  coast,  all  having  good  and  spacious 
harhiirs,  namely,  Edenton,  Beaufort,  No wberne  and  Wilmington.  Of  these  th(^  portijf  Wil- 
iuin«t"ii  is  the  only  one  of  importance  for  (luarantino  purposes.  Dr.  Thomas  F.  Wood, 
Secretary  of  the  North  Carolina  State  Board  of  Health,  writes  as  follows  concerning 
iin.irantine  at  this  port: 

"111  reply  to  your  letter  of  inquiry  No.  20, 613, 1  would  say:  Our  quarantine  facilities  aro 
inadeciuate.  The  quarantine  station  is  at  the  mouth  of  Cape  Fear  Iliver,20  miles  from  Wil- 
mlniitoii.  At  this  station  certain  vessels  aro  requlreii  to  proceed  at  once  to  the  station  for 
inspection.  The  quarantine  offlcer  is  appointed  by  the  Governor.  He  lives  at  the  station 
and  has  Immediate  charge  of  all  the  details  of  dislntoction,  cleansing,  unloading  and  po- 
lli.'edireetion  of  the  detennos. 

"In  all  eases  of  doubt  he  submits  his  case  to  the  advisory  quarantine  board,  two  gen- 
tlemen, selected  by  the  President  of  the  State  Board  of  Health,  who  reside  in  Wilmington. 
Ea(h  vessel  Is  treated  upon  its  individual  merits,  and  the  rules  are  made  elastic  enough  to 
apply  tu  ear-h  case. 

"Our  met!  lis  of  disinfection  are  primitive.  The  vessel  is  unloaded,  bilge  is  pumped  out 
iindfnsh  water  pumped  in  until  it  is  discharged  clear  and  odorless,  and  the  disinfection 
is  completed  by  burning  sulphur  under  closed  hatches.  The  vessels  are  unusually  small, 
iindcomi'  in  ballast,  and  as  they  iire  not  numerous  th(fre  is  little  difflculty  in  performing 
satisfactory  cleansing.  When  there  is  doubt,  the  vessel  is  required  to  load  at  the  station, 
the  cargo  lieing  carried  to  it  in  lighters. 

"Sliould  a  vessel  put  in  with  cholera  on  board,  we  would  relieve  the  recessities  and 
haveher  towed  to  Sapelo  Station.  If  her  crew  was  small  we  would  keep  her  under  obser- 
vation, ami  treat  the  men  on  board.  The  quarantine  hospital  was  burned  two  years  ago, 
and  the  State  has  not  rebuilt  it." 

I)r.  Wood  encloses  a  printed  copy  of  the  (luarantine  regulations,  but  as  these  are  suf- 
lloienth  summarized  in  his  letter  they  are  omitted  from  this  repo,rt. 

South  Carolina: 

The  quarantine  system  of  South  Carolina  is  governed  by  the  provisions  of  a  state  law, 
approved  December  20, 1881,  entitled  "An  act  to  render  more  efTlcient  the  quarantine  aer- 
vioeotllie  several  ports  of  the  State."  Under  this  enactment  the  administration  of  quar- 
antine at  the  port  of  Charleston  is  placed  in  charge  of  the  Board  of  Health  of  the  city.sub- 
jectto  the  advice  and  supervision  of  the  executive  eoncmittee  of  the  State  board  of  health. 
Atthe  other  ports  of  the  State  quarantine  remains  under  the  supervision  and  control  o 
this  latter  body,  and  the  stations  at  Georgetown  on  South  Island,  at  St.  Helena  entrance 
on  Buzzard's  Island,  and  at  Port  Royal  on  Paris  Island,  have  received  special  attention 
since  the  danger  of  cholera  importation  became  imminent.  Many  of  the  buildings  have 
b'en  repaired,  and  new  ones  have  been  erected  on  the  site  purchased  last  year  on  Buz- 
zard's Island. 

The  following  regulations— which  are  uniform  with  those  in  force  atthe  Georgia  quar- 
antine stations,  so  far  as  relates  to  foreign  vessels— govern  the  quarantines  of  South  Car- 
olina: 


!/» -ii* 


M' 


I.  On  and  nftor  tho  openinK  onuli  year  of  tiic  National  Quarantino  Htutlon  (Hapelo 
Boiinil).  all  vHHsoIrt  from  tnfootod  or  HUHpoiUed  liiHtiiiloH  iirrlvliijf  with  Blokni'sa  on  board, 
or  havinK  liad  Hiitnc  diirInK  voyage,  must  b«  dlnvtod  hy  thi-  t>ll"t  to  proceed  to  huW 
National  Quarantine  station. 

II.  Any  vcsHol  arrlviim  nt  tills  port  lirarlng  thn  i-ertlllcato  of  tlic  National  (Juanintine 
onicor,  mu-it  Im' brouKlit  to  anchor  at  tlio  iiuarantlne  station,  and  thorr  remain  until  re- 
leasf'd  by  the  oriler  of  the  board  of  health. 

III.  DiirltiK  the  closure  of  said  National  Ouaranflne  station,  all  vessels  suoh  as  abovi- 
doHorlbed,  must  anchor  at  the  port  (luarantlne  station,  under  perwonal  direction  of  the 
auarantine  olllcor. 

IV.  Vessels  from  any  forel^'n  port  direct,  or  via  American  ports,  with  or  witliout  sick- 
ness on  board  will,  durinK  the  entire  year,  be  compelled  to  anchor  and  remain  at  the 
<iuaranline  station  until  released  by  written  permit  of  tho  iiuarantlne  ofllcer. 

V.  All  vessels  arriving  at  this  port  with  sickness  on  board,  or  havint;  had  same  durlri; 
voyage,  will,  at  all  stjason-i  of  the  year,  no  matter  from  what  port,  either  American  or 
foreign,  anchor  at  the  ciuarantlne  station,  and  there  remain  until  released  by  order  of  th'' 
Board  of  Health. 

VI.  Vessels  from  Infected  or  suspected  latitudes,  will,  during  the  entire  year,  1)8  re- 
(luired  to  discharge  any  and  all  biillast  at  the  (luarantlne  station,  oi'  sueh  other  plai.'i' ns 
may  be  designated  by  tlie  liealth  authorities,  in  tlie  liarbor  undei'  water;  to  have  bilges 
and  limbers  cleaned  and  sweetened,  and  from  May  1  to  Niivember  1st  of  each  year,  be 
subjecled  to  at  least  two  fumigations  and  buch  otherdisinfeciion  as  may  be  necessary, iinJ 
be  detained  at  least  fifteen  days. 

VII.  On  and  after  May  let,  and  until  November  Ist  of  each  year,  and  longer  if  the 
board  of  health  so  determine,  all  coas-twise  vespels  or  steamers  from  latitudes  south  of 
Cap(!  Hatteras,  other  than  thos((  liy  inland  route,  musi  anchor  at  the  (luaraniine  station. 
Steamers  and  vessels  from  non-infected  '-'•  non-suspectt'd  ports,  will  not  be  detained 
longer  than  necessary  for  the  (luanintine  oltleer  to  satisfy  himself  of  their  perfect  s^auitiiry 
condition.  Vessels  from  infected  or  suspected  latitudes  will  have  to  comply  with  section 
VI,   be  fumitrated  at  least  twice  and  detained  at  ii.'ast  llfteon  days. 

VIII.  Coastwise  steamers  and  vessels  arriving  at  this  port  by  inland  route,  from  iuti- 
t.udes  south  of  Capo  Hatteras,  between  May  Ist  and  November  1st.  and  later,  if  the  Board 
of  health  so  determine,  mubt  be  inspected  and  trlven  perndt  by  the  <iuarantino  ofllcer, be- 
fore thi-  landing  of  oithei-  passengers  or  freight. 

IX.  From  May  1st  to  November  1st  ot  each  yeai*.  no  vessel  from  an  Infected  or  sus- 
pected latitude  will  be  allowed  to  either  lighter  or  bring  cargo  of  fruit  up  to  the  city. 

X.  Pilots  must,  in  each  case,  before  boarding,  make  inquiry  ns  to  the  sanititry  condi- 
tion of  vessels;  in  no  case  must  they  board  if  the  vessel  has  sickness  on  board,  or  has  had 
same  during  voygae;  in  such  cases  tliey  must  either  direct  to  iSapelo  Quarantine  station, 
lead  tho  vessel  in,  or  have  their  small  boat  hoisted  alongside,  clear  ot  the  water,  ami  in 

Ms  way  pilot  the  vessel  in. 

Dr.  H.  B.  Horlbeck,  (Uty  Itegistrar  and  Secretary  of  the  Charleston  Board  of  Heiiltli, 
furnishes  tlia  following  Information  concerning  the  station  at  the  port  of  Charle-.ton: 

The  station  at  Fort  Johu'^on,  on  Jam(!s  Island,  is  about  two  miles  east  from  Cli.iHcstoii 
in  the  harbor.  Tlie  buildings  comprise  a  fever-hospital  and  pest-house,  offices,  etc.  Tlier<' 
is  a  fine  and  conimodious  wharf,  also  boats  for  boarding  purposes,  under  care  of  a  iimu- 
antine  olTlcer,  andaguard  boat.  Service  is  maintained  from  May  1st  to  Noverabcr  Ist 
every  year,  to  prevent  uiuiuthorized  communication  w  ith  the  Station.  Tills  service  is  also 
continued  from  November  to  May  when  necessary.  Vessels  are  inspected  at  tlie  station 
jn  tho  stream.  They  are  fumigated  with  sutphurou^-aeid  gas,  and  disinfected  witli  tlie  bi- 
chloride-of-mercury  solution.  Cargoes  of  fruit  from  infected  ports  are  not  permitted  to  go 
to  the  city  from  May  1st  to  November  1st,  and  certainly  no  other  cargo  until  it  lias 
been  taken  out  of  the  ship  at  tho  station  and  fumigated  (see  quarantine  regulations,) 
Vessels  arriving  pass  within  a  few  hundred  yards  of  vessels  detained  at  quarantine.  No 
vessel  from  a  cholera  port  is  allowed  to  come  in,  but  is  ordered  to  Sapelo.  Should  a  vessel 
have  either  cholera  or  yellow  f(!ver  break  out  at  quarantine  it  would  be  sent  to  Sapuloiu- 
stanter,  or  on  the  next  tide -that  is,  certainly  within  twelve  liours." 


28 


Georgia  : 

In   .(.  'r.  McFarhinil,  H^ftltliOnioer  of  Siiviinnnli.  fmnlHliBH  the  follovvlny  !n  resroiiBeto 

my  l.'ttor: 

"Tlif  iiiiaranllne  Htatlop  Ih  locatod  seawanl  of  the  olty,  iliHtant  l)»«twi'Pn  fonrttxdi  ami 
ilftt'i'ii  mlltiH,  upon  an  oyntor-betl  8lioal;  this  nlioal  in  ontlrely  Hiirroiinded  by  water  and  Ih 
covi'ii'il  alioiit  four  foot  In  overy  Hood  lido.  ()n«  nhort  angh'  of  tlio  rlv«'r  clianncl  riiUH 
wiiliin  about  throe  huiidrf'd  yardH  of  tlin  Hiatloii.  All  voshuIs  fi'oni  Infected  or  HU^*ptH:ted 
parts  and  latifudeti  are  reiiulred  to  dlMfharge  ballast  all  lh<'  year  round  at  fhi-<  (luarantlne 
(ttatinii.  No  t)allaHt  from  tifc  Went  Indies,  or  HUMr>"''ted  ioijalltloH  north  of  ltl(>  de  Janelio, 
liiis  lit'cn  allowd  to  be  liroiiBlit  to  tli"  (dly  of  HavanniiliHlncn  187i;.  'I'lilsrumilatlon  wanln- 
i*titiifi'(l  a.s  a  Kiiard  aKiiiiist  yellow-fover  introduction. 

"Tlio  fai-illtieH  of  the  ntation  ai'o  not  as  Kreat  an  are  reiiulri'd;  an  Increase  of  wharfiitre 
iind  the  erection  of  a  storoliouHe  are  needed. 

"All  vcshcIh  are  Inspected  at  lht>  (luarantlne  station  by  tlm  resident  pliyHlcian.  VoHsi.>l8 
liii'iiiK'),  from  loreiirn  portw,  seldom  como  to  this  port  between  May  1  and  November  1.  I 
IwIIhvb  this  Is  the  case  at  the  other  Soulli  Atlantic  ports.  Durlnuthis  season  but  one  vesse 
In  caiK"  (Kiiano)  )ias  arrived  here.  CoiYee  vessels  liave  been  in  the  liabit  of  comiisK  to  1ld« 
[idit,  and  hav(^  been  reiiuired  toundfrgo  sulphur  fuuilgation  with  cargo  in  i>laco;  the 
funii'-i  of  tlie  gas  do  not  lejure  tlie  quality  of  the  bean  In  the  sliglitest  degree.  The  cargo 
istlu'ii  allowed  to  betaken  by  llglilers  to  the  city,  while  tlio  vessel  is  dotauKHl  ar  the  sta- 
tion; lier  bilges  and  timbers  are  cleansiul  and  disinfected  witli  solution  of  sulphate  of  iron 
or  liii'lil<jrlde  of  mercury,  and.  along  with  all  clothing  and  bedding,  she  is  then  subjected 
to  a  si'i'ond  fumigation.  The  requirements  Having  been  carried  out.  and  no  sickness  hav- 
Ini;  occurred  on  board  during  detention  time,  permit  Is  granted  by  the  health  ofllcor  for 
vessi'l  to  come  to  the  city.  The  clothing  on  board  aiiy  sucli  vessel  is  subjected  daily, dur- 
intrcictention,  to  the  action  of  fresh  air,  all  bedding  and  clothing  being  exposed  on  deck 
of  vessel  and  in  some  cases  these  iire  subjected  to  boiling.  Fumigation  with  chlorine  gas 
i.s  friMiuently  resorted  to— always  when  there  Is  any  suspicion  of  smull-pox  Infection. 

"So  soon  as  cholera  became  epidemic  in  Spain  this  past  summer,  orders  were  issued 
to  the  pilots  of  this  i)ort,  not  to  board,  but  to  direct  to  the  Sapelo  Quarantine  station,  any 
and  till  vei^sels  arriving  from  ports  infected  with  cholera.  This  National  Quarantine  sta- 
tion is  distant  only  about  sixty  miles  from  the  mouth  of  the  Savannah  river.  It^cently 
orders  have  been  issued  allowing  pilots  to  lead  to  the  port  quarantine  station  any  vessel 
from  the  Mediterranean  coast,  when  sue  li  vessel  has  not  had  deatli  or  acknowledged  infec- 
tions diseasi!  aboard  during  her  voyr.ge.  This  change  of  order  was  made  in  conwequence 
of  the  decrease  of  cholera  in  Europe.  These  vessels  were  ordered  to  the  National  Quar- 
antine station  because  they  were  all  deemed  entitled  to  thorough  cleansing,  and  tlio  health 
authorities  of  Savannah  decided  that  It  cholera  did  make  its  appearance  on  board  any  of 
them  while  having  the  clothing,  bedding,  etc..  attended  to,  it  would  be  decidcMlly  prefer- 
able to  have  them  away  from  this  port.  Vessels  arriving  at  this  port  from  yellow-fover 
latitudes  are  not  boarded  by  the  pilots.  Such  vessels  are  led  into  quarantine  grounds  if 
they  have  not  had  sickness  on  board  during  voyage.  If  they  have  had  sickness  on  board 
during  voyage,  wliich  the  captain  acknowledges  to  have  been  susr^icious,  he  is  directed  to 
the  Siipclo  station.  If  any  vessel  arrives  at  the  port  quarantine  station  and  it  is  deter- 
mined after  investigation  that  she  has  liad  infectious  or  contagious  disease  on  board, she 
is  imiiied lately  ordered  to  leave  the  port,  and  is  directed  to  th(!  National  Quarantine  sta- 
tion. This  refuge  is  umiuestionably  a  very  great  safeguard  and  help  to  this  portion  of  the 
.\tlantie  coast,  and  in  helping  and  protecting  us  it  protects  the  country  at  large. 

"Should  a  vessel  o'-ivc  at  this  port  with  cholera  on  board,  and  the  National  Quarantine 
stati'.n  be  closed,  the  .-:iip  would  bo  placed  at  the  greatest  distance  from  line  of  trav(!l  (say 
three-fourths  of  a  mile)  and  guard  boats,  with  most  reliable  crows,  would  prevent  any 
eommuiiication  with  or  from  her,  excepting  the  quarantine  physician,  who  would  have  to 
remain  and  look  after  the  sick.  Tolographic  communication  would  be  opened  at  once 
with  the  authorities  at  Washington,  asking  the  immediate  opening  of  the  National  Quar- 
antin  ■  station.  If  such  station  was  opened  the  vessel  would  bo  sent  there.  If  it  was  not 
opened  the  health  authorities  of  Savannah  would  have  to  assume  the  responsibility  and  do 
the  best  in  their  power  to  prevent  the  apracd  of  the  disease. 


( 


24 


rm^  ■     ,:. 


il^-  -SaiiBiiitii/tatm 


"In  closinK  I  iMQnot  rofraln  from  an  expression  of  contli<mnation  and  pi'otost  ajjiiinst 
the  unre'ilnbility  of  tho  ordinary  bills  of  health  Issiii'd  by  somo  consuls  of  the  United  Htatos. 
They  are  worse  than  usuless,— tliDy  are  daagerous.  It  is  a  froauont  occurrence  that  clean 
bflis  of  health  are  Issued  by  Ihem  at  ports  whore  deadly  epidemic  diseases  are  prevailing. 
'I'here  should  he  some  remedy  for  such  pernicious  and  ciuostlonable  conduct.  Ayaln,  I 
know  positively  that  steamship-*,  from  districts  of  Spain  affected  terribly  with  cholera, 
have  been  admitted  into  one  of  thn  largest  ports  of  the  United  ataten,  during  this  season, 
without  the  slightest  attempt  at  fumlgitionof  the  clothing  of  seamen,  or  cleansing  of 
vessels,  tho  statement  being  made  to  me  in  official  correspondence,  tliat  as  no  sickness 
had  occurred  during  the  voyage  it. was  doomed  unnecessary  to  use  any  precautions,  i.nd 
that  this  would  be  the  line  of  action  pursued  in  the  future  at  that  port." 

Dr.  Jas.  8.  Blain,  Health  Officer  of  Brunswick,  answers: 

1.  The  (luaruntlne  facilities  of  Brunswick  are  not  so  perfect  as  I  would  like  to  have 
them;  but  they  have  proven  sufficient  to  protect  this  city  from  all  epidemic  infectious  and 
contagious  diseases  since  tho  yellow-fever  epidemic  of  1870. 

2.  I  Inspect  all  vessels  at  a  distance  of  from  four  to  ten  miles  from  the  city.  All  vessels 
are  Inspected  befon;  permission  is  granted  to  proceed  to  the  city. 

:>.  Vessels  are  purided  and  disinfected,  first  by  the  dlschaigo  of  all  bulla!:.!  or  cargo; 
secondly,  the  jilanklng  along  the  keelson  is  taken  up.  all  filth  eolloctod  in  the  limbers  of 
the  vessel  taken  out,  and  the  vesiol  thoroughly  washed  and  pumped  out,  salt  water  being 
used  until  tho  vessel  is  perfectly  clean;  thirdly,  a  strong  solution  of  carbolic  acid  and 
sulphate  of  Iron  is  applied  to  the  whole  interior,  and  the  vessel  Is  then  fumigated  by  burn- 
ing from  100  to  aon  lbs.  of  sulphur  in  the  cabin,  forecastle  and  hold  of  the  vessel.  All  bed- 
ding and  clothing  of  the  crow  is  subjected  to  cleans;  ••:?  and  disinfection.  All  infected  or 
suspected  vessels  are  detained  ten  days  after  cleansing,  then  if  no  case  of  disease  appears 
tho  vessel  receives  a  permit  to  proceed  to  the  city. 

4.  The  quarantine  station  is  four  miles  from  the  city;  it  is  not  out  of  the  line  of  travel, 
but  no  intercourse  v»dth  vessels  In  (luarantlno  Is  permitted. 

5.  All  vessels  with  sickness  on  board,  and  all  vessels  from  cnolera  infected  or  sus- 
pected ports  whether  or  not  having  sickness  m  board,  arc  sent  to  Sapelo  Sound.  All 
pilots  and  steam  tugs  on  this  bar  have  permanent  instructions  to  order  all  vessels  witli 
si' kness  on  board  or  from  cholera-infeeted  ports  to  Sapolo  Sound.  Pilots  are  not  per- 
mitted to  board  such  a  vessel,  but  are  instructed  to  direct  or  conduct  them  to  Sapelo 
Sound.  Afier  discharge  from  the  National  Quarantine  sta'ion,  all  vessels  are  again  in- 
t  looted  at  this  Quarantine  station  before  receiving  a  permit  to  proceed  to  the  city. 

Florida ; 

Notwithstanding  its  extended  eoast  of  nearly  1,2(fl)  mili's,  Florida  has  few  harbors  in- 
viting foreign commeieo,  and  except  Fernaudli;a  and  Pensucola,  the  relations  of  Its  seven 
ports  of  entry  to  the  interior  are  limited.  A  State  onactm(mt  approved  February  iti,  ISSS, 
provides  for  the  appointment  of  county  boards  of  health  which  are  clothed  with  full  power 
to  act  In  rogiird  to  all  matters  pertaining  to  auarantlne,  to  appoint  a  port  im^pector  and 
other  officers,  to  declare  and  establish  uuaranline  and  provide  rules  and  regulations  for 
its  enforcement,  and  "after  the  establishment  of  any  (luarantlne  against  any  port  or  plaee 
any  person  violating  the  same  shall  be  dtiemod  guilty  of  a  felony,  and  upon  conviction 
thereof,  shall  b  '  punished  by  a  line  of  not  more  than  live  hundred  dollars,  or  by  imprison- 
ment in  the  state  penitentiary  not  more  than  one  year." 

Under  this  law  the  (luarnntine  of  the  port  of  Ponsaeola  is  now  administered  bv  the 
Escambia  county  board  of  health.  The  station  is  on  Santa  Kosa  Island  about  nine  miles 
from  the  port,  and  is  described  by  the  (niarantlne  physician.  Dr.  White,  in  reply  to  my  in- 
quiries addressed  to  Dr.  II.  IJ.  S.  Hargls,as  being  supplied  with  "all  the  buildings  necessary 
for  fiuarantino  purposes.  Vessels  are  inspected  at  the  station.  Vessels  detained  arc  re- 
quired to  discharge  all  ballast,  and  after  discharge  of  ballast,  tho  vessel  is  thoroughly 
cleansed  and  waslied  in  all  its  parts,  then  fumigated,  using  12  pound.°  of  sulphur  to  evi'ry 
lOO  tons  registered,  the  fumigation  lasting  12  hours.  After  fumigation,  a  saturated  solution 
of  copperas  Is  poured   through  the  air-streaks,  betwei-n  each   timber,  running  down  to 


>?S6.:> 


25 


'  ,7 


tmd  protest  ajcaliist 
)t  the  United  8t,atos. 
currence  that  oleiin 
[vscs  are  prevailing. 
I  conduct.  Again,  I 
•ribly  with  choleni, 
during  tiiis  season, 
on.  or  cleansing  of 
tliat  as  no  sickness 
ay  precautions,  i.nd 


I  would  like  to  have 
omic  infectious  and 

;heclty.    All  vess(!ls 

ill  ballat.t  or  cargo; 
id  in  the  limbers  of 
lilt,  salt  water  being 
Df  carbolic  acid  and 
fumigated  by  burn- 
he  vessel.  All  bed- 
ion.  All  infected  or 
3  of  disease  appears 

)f  the  line  of  travel, 

3ra  infected  or  sus- 
Sapelo  Sound.    \\\ 

dcr  all  ve.isels  with 
Pilots  are  not  por- 

ict  them  to  Sapelo 

^sels  are  ayainin- 

d  to  the  city. 

as  few  liarbor.s  in- 
lations  of  its  seven 
1  February  Iti,  IHi5, 
bed  with  full  power 
port  ini^peetor  and 
nd  reguiatidus  for 
t  any  port  or  place 
id  upon  conviction 
rs,  or  by  imprison- 

Iministered  by  the 
d  about  nine  miles 
n  reply  t'J  niy  in- 
•uildinKs  necessary 
Is  detaiiioJ  arcu'e- 
)ssel  is  thoroughly 
)f  sulphur  to  I'vcry 
saturated  sukition 
,  running  down  to 


bilge;  lime  water  (wliltewash)  used  in  name  manner.  The  entire  hold  Isthen  whitewashed, 
lime  put  In  bilge  to  the  forecastle,  with  bedding,  clothing,  etc.,  under  the  same  process  of 
ilcansing,  fumij^atlon,  etc.,  the  cabin  receiving  same  attention. 

"It  is  not  probable  that  a  vessel  with  cholera  on  board  will  arrive  at  this  station,  as  all 
vessels  arriving  outside  the  entrance  of  the  port  upon  which  any  contagious,  infectious 
or  pestilential  disease  ueeurrcd  during  the  voyage  are  sent  to  Ship  Island,  the  pilot  co- 
operating with  the  local  authorities  in  directing  them  to  that  station.  Should,  however, 
a  vessel  get  to  this  station  with  cholera  on  board,  and  in  such  a  condition  that  she  could 
not  bo  sent  to  Ship  Island,  the  sick  would,  if  possible,  be  cared  for  In  hospital,  and  the  vessel 
put  in  bi'st  sanitary  condition,  and  such  bedding,  clothing,  etc.,  as  could  not  be  disinfected 
would  be  destroyed." 

Dr.  Alexander,  Port  Physician  at  St.  Augustin-J,  writes  that  the  (luarnntine  flag  for 
that  port  "stands  about  one  and  tliree-fourth.'-'  miles  from  the  city,  where  all  vessels 
from  a  distance  are  Inspected,  Coasting  vessels,  or  those  plying  between  this  and  near 
ports,  are  allowed  to  come  to  the  wharf  for  Inspection,  provided  there  is  no  sickness 
on  Ijoard;  if  there  Is,  then  they  share  th(>  auarantine  ground  as  all  others.  Even  upon 
coming  to  the  wharf,  no  communication  is  allowed  until  inspected.  Our  pilots  are  re- 
nnired  to  learn  from  the  captain,  before  boarding  a  vessel,  whether  she  is  from  a  sus- 
pected port,  or  has  on  board  a  suspected  case.  In  the  first  case,  she  is  brought  with 
as  little  contact  as  possible  inside  the  harbor,  there  anchored  and  report  made  to  port 
physicnin  and  board  of  health.  If  sickness  is  on  board,  she  Is  directed  to  pioceed 
directly  to  Sapelo  Sound  refuge  station  without  boarding  or  entering  harbor  here. 

"Should  necessity  demand  the  treatment  of  a  vessel,  we  would  use  the  disinfectants 
reeomniended  by  the  National  Board  of  Health  and  adopted  generally,  viz:  sulphur, 
sulphate  of  Iron,  carbolic  acid,  etc.,  subjecting  cargo,  clothing,  bed-clothes,  etc.,  to  the 
same,  and  burn  what  might  endanger  after-dlslnfectloh. 

"A  vessel  entering  with  contagious  disease  would  not  be  allowed  to  remain  one 
hour,  as  the  condition  of  our  harbor  would  subject  the  whole  city  to  immediate  In- 
fection; even  should  a  vessel  coming  from  foreign  ports  be  In  perfect  health  and  con- 
dition, she  must  stop  at  quarantine  ground,  and  all  circumstances  connected  with  her 
trip  be  well  considered  by  the  board  of  health  before  allowing  her  to  come  up. 

"The  coast  map  will  show  our  unfortunate  i)osition  as  far  as  receiving  or  entertain- 
ing a  vessel  with  disease  on  board.  Our  proximity  to  the  high  seas,  the  short  and  ex- 
tremely narrow  Inlet,  could  but  endanger  us  under  the  most  favorable  circumstances, 
as  the  small  craft  or  pleasure  boat  would  pass  less  than  one  hundred  yards  from  the 
anchorage." 

No  responses  have  been  received  to  repeated  reuuests  for  information  from  Key 
West  and  elsewhere. 

Alabama :        , 

The  coast  quarantine  of  Alabama  Is  limited  to  one  port  of  entry— Mobile,  and  con- 
cerning this.  Dr.  Jerome  Cochran,  the  State  Health  Officer,  has  kindly  furnished.  In 
response  to  my  imestions,  the  following  succinct  replies,  which  fully  cover  all  the  im- 
portant points: 

1.  The  Mobile  (luarantine  station  is  chiefly  an  Inspection  station,  but  has  the  ordi- 
nary appliances  of  dlsinfeetloii. 

L'.  The  entrance  from  the  Gulf  of  Mexico  into  the  Bay  of  Mobile  is  thirty  (30)  miles 
from  the  city,  and  vessels  are  boarded  for  inspection  at  this  entrance. 

:?.  Vessels  from  infected  ports  with  no  sickness  on  board  are  disinfected  anyhow 
before  they  are  allowed  to  api)roach  the  wharfs. 

4.  Vessels  with  any  infectious  sickness  on  board,  cr  having  had  any  cases  during 
the  voyage,  are  sent  at  once  to  Shiii  Island.  Such  vessels  are  not  allowed  to  enter  the 
Bay  at  all  until  released  from  (luarantine  by  the  Ship  Island  olflcials. 

5.  Moblh*  is  thoroughly  in  earnest  about  her  quarantines,  and  no  infectious  disease 
lias  been  introduced  througli  the  imarantine  into  the  city  since  the  war.  Such  outbreaks 
as  we  have  had  have  been  the  result  of  infection  brought  overland  from  New  Orleans. 


'.t:-'!:;-}. 


26 

6.  Any  vessel  having  on  board  a  the  time  of  its  arrival,  or  haviiiji  had  on  board 
at  any  time  during  the  voyage,  yellow  fever  or  cholera,  would  bo  sent  to  Ship  Island 
at  once,  and  not  allowed  to  entur  the  bay  at  all  until  diseharKed  from  the  station,  and 
even  then,  if  tliore  was  any  suspicion  that  she  stili  remained  danyerous,  she  would  be 
disinfected  anew  at  our  own  station," 

Mississippi : 

Tlic  county  boards  of  health  of  Hancock,  Harrison  and  Jackson  counties  eimtrol  the 
maritime  quarantities  of  Mississippi.  There  is  no  direct  foreign  commerce,  but  Bay  St. 
Louis  has  a  larKC  coasting  trade  with  Mobile  and  Now  Orleans,  and  acquires  some  quaran- 
tine importance  in  conso(iuence. 

Louisiana : 

The  quarantine  system  of  Louisiana-  is  under  the  control  of  the  State  Uoard  of  Health, 
which  is  authorized  by  various  acts  of  the  State  LeRislaturo  to  ilx  the  duration  of  quaran- 
tine and  to  make  and  enforce  all  necessary  reyula'ions,  to  contract  for  building,  employ 
persons,  etc.  At  ts  discretion  the  Board  may  atany  time  cause  the  detention  at  the  quar- 
antine stations  f(  r  disinfection,  fumigation  and  pwrlilcation,  of  any  or  all  vessels  from 
ports  in  which  yellow  fi'ver  usually  prevails  or  from  ports  where  other  contagious  or  in- 
fectious disease  is  reported  to  exist.  Quarantine  stations  are  ostatlishod  by  law  on  the 
Mississippi  river  not  less  than  70  miles  below  New  Orleans,  at  the  Rigolettos— the  entrance 
to  Lake  I'ontchartrain— and  below  Morgan  City  on  the  AtchafaUiya.  But  the  State  Board 
is  also  empowered  to  establish  additional  stations  upon  any  of  the  approaches  to  the  city 
of  New  Orleans  in  its  discretion. 

Under  this  latter  authority  the  present  Board  has  recently  established  a  refuge  station 
in  Pas  a  L'Outre.  some  28  miles  below  the  original  station,  which  latter  is  on  the  right  bank 
of  the  Mississippi  75  miles  below  New  Orleans.  A  boarding  station  is  also  maintained  at 
EadsDort  at  the  head  of  the  jetties. 

Accompanied  by  Dr.  Joseph  Holt,  President  of  the  State  Board,  and  to  whoso  indefati- 
gable energy  the  recent  practical  improvt-ments  are  mainly  due,  I  made  a  personal 
inspection  of  the  Mississippi  river  stations  on  the  l.'ith.  Kith  and  17th  of  July  last,  and  wit- 
nessed the  inspection  of  vessels,  the  disinfection  and  treatment  of  an  arrival  from  an  in- 
fected port— a  2000-ton  iron  steamer:  Inspected  another  which  had  been  treated  two  days 
before'my  arrival  and  was  not  yet  released;  examined  the  appliances  for  disinfection,  etc., 
and  the  buildings,  hosnitals,  warehouse  and  other  items  of  the  quarantine  plant.  I  am, 
therefore,  enabled  to  endorse  from  personal  observation  the  claim  made  that  this  is  the 
most  thorough  and  vigorous  system  of  sanitary  quarantine  which  has  ever  been  enforced 
for  the  protection  of  a  port  from  the  introduction  of  foreign  contagion  into  this  country— 
if  not  In  the  world. 

Beginninj:;  with  the  arrival  of  a  vessel  in  soundings  she  is  met  by  the  pilot,  who  co- 
operates with  tlie  (luarantine  authorities  and  is  freiiuently  accompanied  by  the  medical 
officer  from  the  boarding  and  inspection  station  at  Eadsport.  This  officer  examines  the 
ship's  log  and  receives  a  sworn  statement  from  the  captain  as  to  the  sanitary  history  of 
his  vessel  and  her  vi>yage,  beginning  at  the  port  of  departure.  All  on  board  are  mus- 
tered and  carefully  examined  for  cases  of  suspicious  sickness.  If  the  vessel  be  found 
in  good  sanitary  condition  and  free  from  infection  slie  is  allowed  to  proceed  up  the 
river,  but  reports  at  the  upper  (luarantine  station  for  a  second  inspection.  If  from  a 
non-infected  port,  she  is  now  given  free  pratique  and  proceeds  to  the  city.  If  from  an  in- 
fected or  scheduled  port,  or  if  any  suspicious  development  has  occurred  in  the  interim 
after  first  inspection,  she  is  either  subjected  to  treatment  at  the  upper  station  or  sent 
below  to  the  refuge  station,  as  thi^  circumstancics  demand.  For  example:  A  shmt  time 
before  my  visit  a  Mexican  steamer  had  arrived;  she  was  inspected  at  the  boarding  sta- 
tion and  all  hands  mustered  and  examined  as  usual,  without  detecting  any  suspicious  ill- 
ness. After  she  had  been  allowed  to  depart  Ihe  pilot  reported  that  a  sick  man  had  been 
roused  from  his  berth  to  be  mustered  with  the  crew.  The  fact  was  at  once  telegraphed  to 
the  upper  station,  and  on  the  arrival  of  the  vessel  the  man  was  founu  to  be  suffering  with 
what  proved  to  be  yellow  fever.  The  vessel  with  the  sick  man  on  board  was  at  once  sent 
down  to  the  refuge  station  for  necessary  treatment,  entirely  out  of  the  track  of  commerce. 


27 


had  on  board 
to  Ship  Island 
he  station,  and 
i,  she  would  he 


tio3  control  the 
ae,  but  Bay  St. 
s  some  quaran- 


loard  (if  Health, 
itioii  of  quf.ran- 
iiilding,  employ 
ion  at  the  iiuar- 
11  vessels  from 
jntaglous  or  In- 
)d  by  law  on  the 
13— the  entrance 
the  State  Board 
ches  to  the  city 

a  refuge  station 
n  the  right  bank 
>  maintained  at 

whoso  indefati- 

i.de  a  personal 
y  last,  and  wit- 
vnl  from  an  in- 
eated  two  days 
sinfection.etc, 
e  i)lant.  I  am, 
that  this  is  the 
been  enforced 
this  country— 

e  pilot,  who  co- 
by  the  medical 
examines  the 
Itary  history  of 
)oard  are  mus- 
essel  be  found 
roceed  up  the 
on.     If  from  a 
If  from  an  in- 
in  the  interim 
station  or  sent 
A  short  time 
boarding  sta- 
suspicious  ill- 
man  had  been 
Iflegraphed  to 
sulTering  with 
as  at  cnce  sent 
:  of  commerce. 


If  a  vessel  on  first  inspection  be  found  infected  she  is  not  allowed  to  proceed  up  the 
river,  but  is  at  onci;  sent  to  the  n;fiiKe  station,  the  sick  are  removed  to  the  hospital,  and  the 
vessel  is  treated  as  hereafter  described.  Afterbeingthoroughly  cleansed  and  disinfected, 
she  is  then  sent  to  the  upper  station,  where  the  compromised  passengers  and  crew  are 
subjected  to  a  auarantine  of  observation  duiinj^  the  usual  period  of  incubation— (h:'pendlng 
upon  the  character  of  the  disease.  For  the  acconimodatiou  of  ihese  the  huge  government 
warehouse  is  utilized.  IVIeanwhile,  the  vessel  may  be  allowed  to  proceed  to  the  city  In 
charge  of  an  acclimated  crew,  or  her  cargo  may  be  sent  up  on  lighti'rs— at  the  discretion  of 
the  (luarantiiie  authorities. 

There  is  one  medic. il  offleer  on  duty  at  the  boarding  station,  one  at  the  refuge  station, 
and  two  at  the  upper  (luarantine— together  with  thi?  ncjcessary  guards,  boatmc^n,  .steve- 
dores, nurses  and  other  employes.  All  the  stations  are  in  telegraphic  communication  with 
each  other  and  with  the  offlcis  of  the  State  Board  in  New  Orleans. 

The  following  extracts  from  recent  h.'tters  of  Dr.  Holt,  written  me  since  my  visit,  suf- 
ficiently explain  the  otlier  details  of  the  pre--ent  quarantine  administration  for  the  protec- 
tion of  tlie  (iulf  gateway  to  the  Mississippi  valley.  Improvements  in  minor  points  have 
since  been  made,  and  others  will  undoubtedly  follow  as  experience  demands  their  neces- 
sity.   Under  date  of  September  8th  Dr.  Holt  writes: 

Tlie  system  coinpreluuids  two  stations.  Tlie  Lower  Station,  for  the  reception  of  in- 
fected vessels  only,  is  situated  at  I'as  a  L'Outre,  an  unused  outlet  of  the  Mississipiii.  The 
isolation  of  this  place  is  complete,  while  affording  anclioi'age  to  vessels  of  any  tonnage. 
As  soon  as  a  vessel  arrives  in  this  station  the  side  are  removed  to  the  hosplial,  where  every 
provision  is  now  made,  for  their  proper  entertainment  anil  treatment.  I'reparati  v  to  the 
disinfection  of  a  vessel,  persons  are  removed  ashore  and  detained  there  until  tin--  process 
is  thoroughly  accomplished. 

Pending  th(>  construction  of  a  receiving  wharf  and' warehouse,  the  freight,  when  the 
requirements  of  disinfection  make  it  necessary,  is  discliarged  into  barge.'",  and  (>very  part 
of  the  vessel  is  then  subjected  to  thorough  treatment.  This  nonsists  in  cleansing  of  the 
bilge,  and  flooding  it  with  bichloride  of  mercury  in  solution,  (me  part  to  one  thousand  of 
wat(>r.  All  surfaces  within  the  holder  below  decks  are  freely  wetted  with  the  same  solution 
arplieJ  as  a  spray  from  a  large  watering  rose,  similar  to  those  used  in  garden  watering- 
pot-,  supplied  through  a  two- inch  hose,  from  an  elevated  tank  on  the  wharf,  or  from  a  tank 
by  means  of  a  powerful  hand-puinp  aboard  the  quarantine  tug-boat.  The  freight  in  the 
liai-fje  or  after  its  return  aboard  ship,  is  subjected  to  the  protracted  action  of  concentrated 
sulphurous-acid  gas. 

This  is  applied  in  the  following  manner:  Aboard  the  tug  there  is  a  compact  battery  of 
twelve  furnaces  for  the  rapid  combustion  of  sulphur  in  large  (luantity.  The  lui'naces 
measure  each  3  feet  6  inches  in  length  by  12  inches  broad  and  7  incln^s  in  height,  and  (con- 
tain, each,  a  cast-iron  pan  3  feet  long,  1  foot  wide  and  2  inches  deep.  Tliese  furnaces  open 
into  a  large  res(.'rvoir,  to  wluch  is  connected  a  driving  or  exhaust  fan  capable  of  displacing 
about  six  thousand  cubic  feet  of  air  per  minute.  It  is  driven  by  an  engine  wliicli  derives 
its  steam  from  tlie  tug  boilers.  The  sulphurous  fumes  are  conveyed  to  the  close  barge  or 
into  the  liold  of  a  ship  through  a  tube  of  galvanized  Iron,  jointed  in  tlie  manner  of  a  stove 
pipe,  twelve  inches  in  diameter,  end  of  a  length  necessary  to  reach  any  part  of  the  ship 
roii'iired.  We  liav(!  now  substituttdfor  this  a  hose  of  asbestos  cloth.  The  V(!ssel  is  detained 
at  this  station  until  there  is  every  i.ssurance  of  her  being  no  longer  infected. 

Th(^  Upper  Quarantine  Station,  situated  on  tiie  left  bank  of  the  Mississippi,  thirty 
miles  above  itti outlets,  is  the  regular  station  at  which  all  v(!ssels  en  route  t(j  the  city  are 
required  to  stop  and  undcj'go  inspe3ti(m.  Tliose  hailing  from  inter-tropical,  American  and 
^"cst  Indian  ports,  and  from  all  the  ports  of  France,  and  from  the  Mediterranean,  are 
subjected  to  the  process  of  disinfection  with  the  mercuric  solution  and  the  sulphurous 
fumes  described.  Evu-y  article  of  ship's  bedding,  etc.,  sailor's  luggage,  clothing  and  bag- 
gage of  ollieers  and  passengers  is  taken  asliore,  where,  on  the  wharf,  it  is  wetted  with  the 
disinfectant  solution. 

Not  having  as  yet  satisfactorily  completed  our  drying  chambers  this  part  of  the  pro- 
cess is  still  inconvenient.    It  is  desirable  that  all  of  these  articles  should  be  dried  out  and 


•28 


.■:-^. 


''j'\'?  ■:■■ 


rotiirned  abonrd  ship  (13  early  as  posslblo.  In  tli<^  meantime  the  vosscl  has  been  troatod 
by  the  tli?infe<-tant  AvettinK  in  every  rmt  iird  every  particle  of  the  atnipsphere  heretofore 
contained  in  her  has  been  displu-ed  by  the  sulphurous  acid  nas. 

Vessels,  to^Jtethor  with  thtiir  cargoes,  ofTleers,  passengers  and  crew,  coming  from  ports 
infected  with  yellow  fever,  are  compelled  to  remain  in  (iiuirantine  a  period  of  live  days 
from  moment  of  arrival,  for  ol)servation,  in  order  to  ylve  a  reasonable  assurance  against 
the  presence  of  the  disease  In  its  incubatory  stages. 

"The  entire  treatment  of  a  vessel  to  prevent  the  introduction  of  cholera,  yellow  fever 
or  small-pox  is  so  exacting  and  so  rigorous  as  to  occasion  no  little  grumbling  on  the  part 
of  those  who  must  undisrgo  it.  This  is  particularly  the  case  with  officers  and  others 
aboard  Mexican,  Spanish  and  Italian  vessels.  Th  >se  persons  resent  any  effort  at  sanitary 
treatment  a^  a  personal  affront  whilo,  In  fact,  they  most  require  it.  They  are  utterly  with- 
out feeling  and  imlifferent  as  to  whether  they  convey  to  our  port  cliolera,  yellow  fever  or 
the  plague.  The  Americans,  English,  French  and  Germans  are  reasonable  in  this  matter. 
I  mentidu  this  as  a  simple  matter  of  experience  in  regard  to  nationalities,  as  wo  have  to 
deal  with  them  in  auarantine. 

"Our  quarantine  methods  represent  the  introduction  of  a  system  of  maritime  sanita- 
tion which  has  already  suggested  many  particulars  of  improvement  and  has  opened  to 
our  view  a  broad  field  of  sanitary  enterprise  far  wider  in  its  possibilities  of  good— first  in 
giving  the  highest  attainable  quarantine  against  the  introduction  of  pestilential  diseases, 
and.  Secondly,  in  removing  foolish  and  untrustworthy  restriction,  destructive  of  inter- 
national commerce  and  travel.  We  have  demonstrated  by  practical  experience  that  tho 
entire  plan  of  treating  ships  in  (inanintine.  or  maritime  sanitation,  can  be  operated  at  a 
vary  moderate  cost  in  ports  doing  a  small  business  in  shipping." 

Tho  following  passages  from  the  letter  referred  to  are  of  special  interest: 

In  using  the  bi-chlorlde  of  mercury,  wei  know  that  %ve  have  one  of  the  most  powerful 
of  all  tho  germicidal  agents.  Practical  test  in  municipal  disiniection  and  in  quarantine  has 
demonstrated  its  absolute  freedom  from  injury  to  those  having  to  do  with  it.  In  the  opera- 
tion of  maritime  sanitation,  our  employes  have  been  wet  with  the  solution  from  head  to 
heels  and  for  hours  at  a  time,  without  having  as  yet  shown  the  slightest  evidence  of  mer- 
eurlalization.  Tlie  clothing  and  other  baggage  of  passengers  and  crew  have  been  soaked 
in  it  witliout  the  slightest  injury  to  persons  or  fabrics.  Injury  to  the  latter  has  always 
been  due  to  the  water  and  not  to  tho  chemical.  The  tlecks,  calkins,  bunks  and  every  avail- 
able part  of  the  vessels  have  been  freely  drenched  with  the  solution  without  injury. 

Tlie  sulphurous-acid  gas,  used  as  the  displacing  agent  of  the  atmosphere  below  deck, 
has  long  sim-e  proved  itself  the  most  i-eliable  gaseous  disinfectant  and  the  least  injurious 
to  cargo  of  any  yet  tried.  As  applied  in  our  (luarantine,  it  is  like  turning  loose  a  volcano 
Into  the  hold  of  a  ship.  'J'he  amount  of  sulphur  used  on  any  one  vessel  varies  from  one 
hundred  and  fifty  to  nearly  three  hundred  pounds,  so  applied  as  to  displace  with  immense 
force  every  particle  of  air  contained  in  the  bilge,  betwei^n  the  planking,  or  skin,  and  ceil- 
ing, in  all  parts  of  the  cargo  and  dunnage.  So  searching  are  these  fumes  under  the 
operation  ot  the  law  of  the  diffusion  ;of  gases,  favored  by  high  pressure  and  rapid  motion 
of  currents,  that  a  bowl  of  rain  water,  buried  in  the  heart  of  a  cargo  of  colTee,  seventy-five 
feet  distant  from  thi' conveying  hose,  was  found  distinctly  impregnated  with  sulphurous 
acid.  'I'lie  effect  upon  tht-  coffee  itself,  w'len  dry  and  in  good  condition,  was  not  obser' 
vable.  By  getting  the  hose  well  into  the  duiuuige,  we  can  now  treat  a  cargo  of  coffee  with 
a  thorcngliness  never  before  contemphited,  and  without  the  extra  expense  to  shippers  or 
consignees  of  a  dollar,  as  against  from  five  hundred  to  eighteen  hundred  dollars  in  times 
past,  when  iiuarantine  treatment  involved  discharging  and  reloading  cargo,  and  the  em- 
ployment of  a  great  gang  of  stevedores,  barges,  tugs,  etc.,  and  even  then  the  disinfection 
was  utterly  worthless,  as  proven  by  the  suljsequent  appearance  of  yellow  feveron  the  ship 
in  port.  If  recent  observations  on  the  destructive  influenci!  of  mineral  acids,  even  greatly 
diluted,  on  the  cholera  virus  arc  true,  then  we  have  in  this  agent  the  most  efficient  adjunct 
to  the  mercuric  solution. 

As  an  Instance  of  unexpected  difficulties  met  with  in  practice,  the  amalgamating 
powers  of  the  mercury  salt  on  pumps,  llttiuKs  of  hose,  nozzles,  spray  roses,  etc.,  presented 


29 


1  been  troatod 
ere  heretofore 

iig  from  ports 
(1  of  five  dnys 
irance  HBtiinst 

I,  yellow  fevt'r 
i«on  tlie  part 
rs  and  others 
art  at  sanitary 
3  utterly  with- 
ellow  fever  or 
a  this  matter, 
as  we  have  to 

'itimo  sanita- 
las  opened  to 
good— first  in 
itial  diseases, 
jtivc  of  inter- 
lence  that  the 
operat('d  at  a 


nost  powerful 
uarantine  has 
In  the  opor'i- 
from  liead  to 
denco  of  mer- 
>  been  soaked 
!r  has  always 
d  every  avail- 
injury, 
below  deck, 
east  injurious 
)se  a  volcano 
ries  from  one 
vith  immense 
kin,  and  ceil- 
cs  under  the 
rapid  motion 
seventy-five 
h  sulphurous 
as  not  obser" 
of  coffee  with 
0  shipp(M-s  or 
iirs  in  times 
and  the  em- 
(lisjnfection 
noQ  the  ship 
even  yreatly 
cient  adjunct 

malgamatlntr 
tc,  presented 


for  awhile  a  most  formidable  difficulty,  finally  overcome  in  a  simple  and  economical  way. 
The  rapidly  destructive  effect  of  the  hcMited  sulphurous-acid  gas  upon  all  flexible  hose  of 
organic  composition,  «;ompellod  us  to  adopt  the  galvanized  iron  tubing,  heavy  and  exces- 
sively awkward  in  use.  This  I  have  completely  ovtTCome  by  having  had  manufactured  a 
closo-wovon,  twilled  or  corduroyed  asbestos  cloth.  While  a  perfect  noni-conductor  of 
heat, this  material  is  abundantly  light,  and  is  proof  against  acids  or  heat. 

Under  date  of  November  11, 1885,  Dr.  Holt  writes:  "In  reply  to  your  letter  No.  W,i  I 
have  the  honor  to  state  that  we  are  maintaining  a  careful  guard  in  the  inspection  of  all 
vessels  from  Mediterranean  ports.  The  process  of  bichloride  disinfection  is  enforced, 
however  perfect  the  health  record  and  clean  the  bill  of  health,  including  a  careful  attention 
to  bilge.  The  only  modification  in  the  full  force  of  treatment  is  the  omission  of  the  atmos- 
pheric displacement  by  the  sulphurous  blast.  This  feature  of  our  system  was  discontinued 
November  1,  the  end  of  our  regular  (luarautine  season. 

"We  are  rapidly.constructing  an  Immense  heating  chamber,  supplied  with  a  double 
steam  coil  from  a  twenty  horse-power  boiler.  The  builders  (Chicago)  insure  the  easy  and 
speedy  attainment  of  250°  F.  This  will  bo  used  in  addition  to  the  bi-chloride  mercury 
wetting.  Any  vessel  not  giving  proof  of  continued  good  health  or,  in  other  words,  show- 
ing any  ground  for  suspicion,  will  be  remanded  to  the  lower  station,  where  she  will  be 
subjected  to  prolonged  and  vigorous  treatment. 

"The  new  system  has  paid  out  of  itself  every  dollar  of  running  expenses.  We  will  open 
it  in  perfect  working  order  as  lo  every  detail  early.ln  May  next.  We  are  fully  Impressed 
with  the  necessity  of  maintaining  vigilance  in  regard  to.eholera."* 

Texas: 

Tue  quarantine  system  of  Texas  covers  a  coast  line  of  some  500  miles,  extending  from 
the  mouth  of  the  Sabine  at  the  Louisiana  boundary  to  the  mouth  of  the  Rio  Grande.  Upon 
the  recommendation  of  Dr.  B.  M.  Swearingen,  the  State  Health  Officer,  the  law  has 
recently  been  changed  so  as  to  relieve  local  boards  of  health  of  the  responsibilities  of  this 
coast  quarantine,  and  the  Governor  is  authorized  to  appoint  State  quarantine  officers,  and 
has  sole  control  of  them  in  the  enforcement  of  the  quaiantine  laws.  This  change  was  in- 
augurated in  the  spring  of  1883,  and  stations  have  since  been  established  and  equipped  at 
the  six  ports  of  entry,  as  follows: 

At  Brazos  de  Santiago,  near  the  mouth  of  the  Rio  Grande,  and  covering  the  port  of 
Brownsville,  the  commercial  gateway  to  the  lower  valley. 

At  Aransas  Pass,  covering  the  gulf  entrance  to  Corpus  Christi  bay. 

At  Pass  Cavallo,  the  entrance  to  Indianola. 

At  Velasco,  at  the  mouth  of  the  Brazos  river. 

On  the  east  end  of  Galveston  island,  for  the  port  of  Galveston. 

At  Sabine  Pass,  the  terminus  of  the  Texas  Trunk  railway. 

Of  these  stations,  that  at  Galveston  is  by  far  the  most  important,  and  its  quarantine 
equipment  is  described  by  Dr.  Swearingen  as  consisting  of  a  steam  tug  fitted  up  with  hot-air 
chambers  and  modern  appliances  for  the  disinfection  of  a  vessel  and  cargo;  a  disinfecting 
war-'iouse  with  a  capacity  for  treating  4,U00  sacks  of  coffee  at  one  time;  and  a  station 
house-the  whole  plant  representing  an  outlay  of  about  $55,000. 

The  station  is  on  the  east  end  of  the  island,  about  two  miles  from  the  city.  Vessels 
from  suspected  ports  are  inspected  beyond  the  bar,  ten  or  twelve  miles  soutliea&t  of  the 
station,  and  are  detained  there,  If  considered  dangerous,  until  the  exact  facta  are  deter- 
mined. If  actually  infected,  they  are  not  permitted  to  cross  the  bar,  but  are  ordered  to  the 
Ship  Island  refuge  station.  If  from  an  infected  or  interdicted  port,  a  quarantine  of  deten- 
tion of  twenty  days  is  rigorously  enforced,  during  wliich  period  the  cargo  may  be  removed 
by  lighters  to  the  disinfecting  warehouse,  and  the  vessel  be  suitably  treated.  From  May  1 
to  the  close  of  the  quarantine  season  in  November,  1884, 939  vessels  were  Inspected  at  this 
station,  and  17  of  these  were  subjected  to  the  20  days'  detention.  All  vessels  are  Inspected 
coming  from  south  of  25°  north  latitude,  and  the  enforcement  of  the  regulations  results  In 
a  practical  exclusion  of  vessels  from  Mexican,  Cuban  and  Brazilian  ports  during  the  sum- 
mer and  fall. 

*  Cholera  was  Introduced  into  this  country  through  this  port  In  December,  1848,  and 
Jn  February,  1873. 


m>  '■■  ^i  ■■■  ■ 

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30 

Yellow  fever  in  the  disease  most  dreaded,  and  the  quarantine  system  has  been  framed 
Hnd  heretofore  admlnlstored  with  reference  to  Its  exclusion.  The  Mexican  authorities 
have  cooperated  by  establishing  a  auariintino  at  Bagdad  in  aid  of  the  station  at  Bruzos 
Santiago  covonng  the  lower  mouth  of  tlie  Bio  Grande,  and  have  adopted  the  same  rules 
and  rogulations  as  those  enforced  at  the  Texas  ports. 

An  in^poction  of  transatlantic  steamers  with  reference  to  cholera  Is  now  maintained 
at  the  six  Texas  stations  and  will  be  continued  throuuhoutthe  winter.  As  late  as  November 
lOlh  of  this  year  there  were  several  steamers  from  chol'era-infected  ports  on  the  Mediter- 
ranean detained  in  (lUrtrautlno  oil'  Galveston.  The  vessels  are  not  allowed  to  come  to  the 
wharf,  but;  are  unloaded  and  loaded  again  by  lighters. 

A  communication  from  State  Health  Officer  Bwearingen  to  the  Governor  ot  the  State, 
<'ommenting  upon  the  efforts  to  e.Uablish  an  international  quarantine,  incidentally  but 
fully  sets  forth  the  principles  upon  which  the  Texas  (luarantlne  system  is  based. 

"Another  very  material  variance  between  the  autliorities  of  the  State  and  those  of 
Mexico,  is  the  length  of  time  thought  to  be  necessary  for  \  nssels  from  infected  places,  or 
places  liable  to  infection,  to  remain  in  quarantine  before  granting  them  free  pruticiue. 
The  Mexican  Congress  of  Hygiene  limits  the  period  tdtendays,  for  what  they  are  pleased 
to  designate  'the  rigorous  quarantine,'  while  in  Texas  twenty  diiv-*  is  the  universal  rule. 

"If  wo  had  disinfecting  wareliouses  at  every  port  of  entry,  and  stoam  tugs  supplied 
with  powerful  exhaust  fans  that  could  drive  out  the  impure  air  from  the  holds  of  ships, 
anti  immediately  after  forpe  into  every  noolc  and  crevlco  germicidal  gases,  the  ton  days' 
period  ot  detention  would  probably  be  sufll'^lent:  but  without  these  appliances  of  purih- 
cation,  a  longer  time  nnqucstior.:ii)ly  gives  greater  security. 

"In  making  the  above  declaration,  I  do  not  lose  'ght  of  the  fact  that  an  infected  ves- 
sel, without  treatment  of  any  kind,  at  the  end  of  twenty,  thirty  or  even  sixty  days  qimr- 
antine,  is  possibly  more  dangerous  than  on  the  ilrst  day  of  arrival.  Tiie  history  of  yellow 
fever  gives  abimdant  evidence  that  thei  poison  does  not  retain  its  infectious  quality  for  a 
long  period  when  exposed  to  pure  air,  and  that  its  proliferous  properties  are  lost.  The 
reverse  is  equally  true.  In  warm,  moist,  impure  air,  its  4nfectious  quality  seems  to  have  no 
limitation,  and  of  course  such  condition  must  favor  its  multiplication.  With  these  facts 
conceded,  the  corollary  is  unavoidable,  that  the  number  of  germs  will  Increase  when 
left  undisturbed  in  the  hold  of  a  vessel,  where  all  these  favorable  conditions  are  found. 
Without  a  warehouse  for  transferring  goods,  we  cannot,  in  ten  days,  by  opening  every 
aperture  for  ventilation,  by  shifting  cargo,  pumping  out  bilge  water,  and  the  free  use  of 
germicidal  gases,  so  disturb  the  condition  of  things  as  to  pronounce  the  ship,  crew  and 
cargo  innocuous. 

"Again,  all  persons  are  not  equally  susceptible  to  the  poison  of  yellow  fever,  and  the 
period  of  incubation  does  not  usually  commence  the  first  day  of  exposure.  If  such  was 
not  the  case  every  unacclimated  person  in  an  infected  city  would  be  down  about  the  same 
time,  and  epidemics  would  be  confined  to  a  few  days,  instead  of  a  few  weoka.  Assum- 
ing, then,  that  the  cargo  of  a  ship  is  infected,  and  that  it  will  take  ten  days  for  the  crew 
to  discharge  it,  the  probabilities  are  that  with  the  majority  of  them  the  period  of  incuba- 
tion would  commence  on  the  eighth,  ninth  or  tenth  day,  instead  of  the  first,  second  or 
third  day,  after  the  work  of  discharging  had  exposed  them  to  infection.  It  follows,  then, 
that  a  ten  days'  quarantine,  when  each  day  brings  additional  exposure  to  those  who  must 
handle  the  infected  goods,  offers  every  opportunity  for  the  germs  of  yellow  fever  to  be 
inoculated  before  the  period  ot  detention  expires,  and  for  the  denouement  to  be  made 
afterwards.  ♦  *         * 

"Twouty  days  quarantine  for  ships  from  interdicted  places,  ten  for  handling  cargoes 
and  ton  more  to  give  time  for  incubation,  h.is  been  the  rule  so  long  governing  the  ports  o 
Texas  that  it  might  be  properly  classed  among  the  rinwritten  laws  of  the  State.  It  is  a 
conservative  period,  a  kind  of  half  way  chronological  station  between  the  opponents  of 
quarantine  on  the  one  side,  and  the  advocates  of  total  non-intercourse  on  tho  other. 
Under  that  rule  we  have  had  no  epidemic,  nor  have  our  commercial  relations  bison 
seriously  impaired  by  it.  The  guarantee  given  of  freedom  from  infectious  diseases  more 
lian  compensates  for  tho  losses  sustained  by  a  policy  that  must  necessarily  divert  certain 
currents  of  trade  into  other  channels. 


31 


1  has  been  framed 
(lean  niithorltles 
station  at  Bruzos 
5(1  the  same  ruloH 

now  maintained 

late  as  November 

ts  on  the  Medlter- 

?ed  to  come  to  the 

irnor  ot  the  State, 
,  Incidentally  but 
is  based. 

3tato  and  those  of 
infected  placoH,  or 
em  free  pratique, 
it  they  are  pleased 
ho  universal  rule, 
am  tuRS  supplied 
he  holds  of  ships, 
ases,  the  ton  days' 
)pliauces  of  purih- 

it  an  infected  ves- 
\  sixty  days  quar- 
e  history  of  yellow 
itious  riuallty  for  a 
ties  are  lost.  The 
y  seems  to  have  no 

With  these  facts 
vlll  increase  when 

tlons  are  found. 
by  opening  every 

d  the  free  use  of 
he  ship,  crew  and 

low  fever,  and  tho 

sure.    If  such  was 

n  about  the  same 

w  weeks.    Assum- 

days  for  the  crew 

period  of  Inouba- 

he  first,  second  or 

It  follows,  then. 

;o  those  who  must 

ellow  fever  to  be 

iment  to  be  made 


"The  people  of  T-xas.  satisfied  with  tho  systemunderwhichthey  have  prospered  for  so 

niiiiiy  years,  will  bo  unwilling  to  take  now  d(^parturoH.  until  tho  etioloKy  of.  yellow  fever  Is 
more  thoroughly  comprohcnded,  and  science  discovt-rs  mort^Jpowerful  agents  for  its  de- 
^ti  action  than  wo  now  possess.  With  duo  deforoneo  to  the  distinguNhod  sanitarians  who 
.(inipos'e  the  (Jongress  of  Hygleno  in  our  sister  republic,  we  could  not  accept  the  ton  days' 
liiiiod  of  detention 'as  a  basi!  for  any  agreement  that  might  bo  entered  into."*      *      ♦      ♦ 

Since  the  date  of  the  letter  from  which  the  foregoing  extracts  are  made  (September, 
iscl)  the  "applianci^s  for  puiillcatlon"  have  boon  furnished  at  tho  Galveston  station.  But 
Dr.  Swonrlng(!n  romnrks  in  a  recent  letter  to  mc,  "although  wo  have;  (at  Galveston)  every 
finiiity  for  inaugurating  a  quarantine  more  in  hnrniony  with  th(!  views  of  sanitarians,  our 
lirdple  are  not  yet  prepar<Hl  for  experiments." 

.\.s  to  land  qunrantlnos,  Dr.  Swoaiingen  says:  "Railways  in  Mexico  make  It  possible 
for  persons,  froiglit,  etc.. to  bo.  transported  from  Vera  Cruz  to  any  city  in  Texas  within  five 
(lays,  via  El  Paso  or  Laredo.  Quarantine  stations  for  the  first  time  wcire  this  year  estab- 
lislied  nt  thost!  points.  I  have  not  attempted  even  an  Inspection  service  against  sniall-pox 
ill  Mexicf).  It  would  be  pui'ely  ornamental  it  I  did  so.  The  Rio  Grande  is  a  shallow  stream, 
111(1  Iroin  El  Paso  to  Brownsville,  by  the  river  bed,  is  probably  two  thousand  miles. 
Siiiiij,'Kling  is  Ciirrled  on  extensively,  and  the  United  States  Govorimient  cannot  prevent 
it.  A  (luarantine  ofllcer  at  any  point,  would  only  be  a  notice  to  these  organized  bands  and 
to  ilie  travelers  of  both  republics,  tliat  they  would  hav(^  to  cross  the  river  higher  up  or 
idwer  down,  'only  this  imd  nothing  more.' 

"lean  enforce  with  some  reason  an  embargo  against  persons  from  Vera  Cruz  when 
yilidw  fever  prevails  there,  for  that  city  is  the  only  nidus  of  infection,  but  when  small-pox 
is  all  over  the  country,  the  extreme  folly  of  such  a  thing  as  an  inspection  at  railway  cross- 
ing's, is  too  apparent  to  lie  discussed."  * 

Should  cholera  be  introduced  into  Mexico  and  becomes  (U)idemic  there,  the  same  condi- 
tions woidd  then  obtain  with  reference  to  the  oxelusion  of  that  contagion.  Dr.  Swoarlngen. 
ailils,  however,  that  Texas  "will  cooperate  with  the  authorities  of, other  Stat(!s,  in  any  dc- 
finsivo  action  against  cholera  Importation  that  may  be  indicated  by  tlie  American  Public 
Ilialth  As.soclation." 

National  Refuge  Stations: 

Theie  still  remains  to  notice  th(!  Refuge  Stations  in  Sapelo  Sound— off  the  coast  of 
(leorgla— and  on  Ship  Island  in  Mississippi  sound.  These  were  originally  projected  by 
tliu  National  Board  of  Health  as  part  of  a  system  intended  for  the  protection  of  the  minor 
ports,  by  providing  fully-equipped  establishments  for  the  care  and  treatment  of  infected 
vessels.  Only  the  Ship  Island  t-tation  was  completed  on  an  adequate  scale,  and  its  chief 
importance  as  a  safeguard  to  the  Mississippi  river  and  the  port  of  New  Orleans  has  been 
IniKely  superseded  by  the  estp,bhshment  of  a  refuge  station  in  Pas  nL'Outre  by  the  Louis- 
iiuia  State  Board  of  Health.  , 

Thesi^'.stallons,  Sapelo  Sound  and  Ship  Island,  are  now  In  charge  of  the  Marine  Hospital 
s  iivico,  together  with  those  in  Hampton  Roads  and  at  the  Delaware  Breakwater,  already 
dosi'ribcd.  . 


handling  cargoes 
rnlng  the  ports  o 
the  State.    It  Is  a 

the  opponents  of 
irse  on  the  other, 
al  relations  been 
JUS  diseases  more 
rily  divert  certain 


